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Pain is usually managed with non-surgical methods such as oral medications, injections and nerve blocks. When these options fail and severe pain turns into a chronic condition, cingulotomy may be the next step for you. Cingulotomy can help significantly relieve pain in 60 to 70 percent of patients who undergo the procedure. This procedure does not target the underlying cause of the pain, but is thought to relieve the suffering associated with chronic pain.
What is a cingulotomy?
Cingulotomy is a neurosurgical procedure in which tissue in the anterior cingulate region (the part of the brain associated with feeling chronic pain) is targeted and altered in a very focused manner. This is also referred to as creating a “lesion.” The process is considered safe and has few side effects. It does not require any implants, long-term maintenance, programming or battery replacements.
Am I a candidate for cingulotomy for pain management?
If medications and other therapies fail to treat your pain symptoms, your doctor may consider surgical options. You may also be a candidate for cingulotomy if you experience:
- Cancer-related pain
- Post-stroke pain
- Atypical varieties of trigeminal neuralgia or facial pain
What happens during cingulotomy surgery?
In preparation for cingulotomy surgery, your doctor will order a specialized MRI to map your brain's anatomy. It will be used to guide the surgery and pinpoint a precise area of your brain.
On the day of cingulotomy surgery, a stereotactic frame will be placed on your head to enable exact targeting and to prevent your head from moving during the procedure. Using your brain MRI, your neurosurgeon implants an electrode in the targeted area of your brain. Patients are awake for part of the surgery so we can test the electrodes and make sure they are in the right place. A local anesthetic is used. Once the target is confirmed, a lesion is created on each side of the brain in a very focused manner using radiofrequency energy.
What to expect after cingulotomy
Cingulotomy relieves symptoms, but it is not a cure. In carefully selected patients, up to 60 to 70 percent experience immediate improvements and long-term relief for at least one year.
Interested in cingulotomy at UCLA? Get prepared for your first appointment.