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Intractable pain and cordotomy
  1. Sebastiano Mercadante
  1. Pain Relief and Supportive Care, Private Hospital La Maddalena, Palermo 90146, Italy
  1. Correspondence to Dr Sebastiano Mercadante, Pain Relief and Supportive/palliative Care, Hospital La Maddalena, Palermo 90146, Italy; terapiadeldolore{at}

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I was interested in the national UK data on percutaneous cervical cordotomy for cancer-related pain.1 They affirm it is effective and early referrals should be considered, rather than analgesics which may be suboptimally effective but also have side effects. This conclusion was based on a median assessment time of 9 days (during which 13% of patients died). Mean survival was just a few weeks. They observed opioid dose reduction from 200 to 140 mg/day of oral morphine equivalents.

I question this. The ‘presumed indication’ for cordotomy, not supported by appropriate …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.