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Cordotomie

  • Jean-Baptiste ThiébautEmail author
  • Vincent d’Hardemare
  • Anne Margot-Duclot
  • Bénédicte Silhouette

Résumé

On estime que, dans plus de 20 % des cas, les douleurs des patients cancéreux sont mal contrôlées par les traitements [1]. Dans environ 80 % des cas, ces douleurs sont dues à la tumeur elle-même : ce sont des douleurs « inflammatoires ». Lorsque, malgré un traitement médical bien conduit, ces douleurs inflammatoires sont incomplètement soulagées, en particulier les accès douloureux paroxystiques et les douleurs provoquées, un traitement invasif doit être envisagé. La cordotomie anté-rolatérale est une intervention chirurgicale introduite dans les années 1900 pour supprimer les douleurs rebelles du cancer. Elle consiste à sectionner ou à coaguler la substance blanche du quadrant antérolatéral de la moelle du côté opposé à la douleur pour interrompre le faisceau spinothalamique qui transmet les messages nociceptifs (Fig. 1). La sensibilité thermoalgique est supprimée en même temps que les douleurs inflammatoires sous un niveau décalé de quelques métamères. L’effet, immédiat, peut durer plusieurs années [2–5].

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Copyright information

© Springer-Verlag Paris 2014

Authors and Affiliations

  • Jean-Baptiste Thiébaut
    • 1
    Email author
  • Vincent d’Hardemare
    • 1
  • Anne Margot-Duclot
    • 1
  • Bénédicte Silhouette
    • 1
  1. 1.Service de neurochirurgie et CETDfondation RothschildParisFrance

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