 Cordotomy involves cutting nerve fibers that run up the front / side (anterolateral) quadrant of the spinal cord, carrying heat and pain signals to the brain. Pancoast tumor pain has been effectively treated with dorsal root entry zone lesioning (destruction of a region of the spinal cord where peripheral pain signals cross to spinal cord fibers); this is major surgery that carries the risk of significant neurological side effects. Cingulotomy involves cutting nerve fibers in the brain. It reduces the unpleasantness of pain (without affecting its intensity), but may have cognitive side effects.
