Interventional procedures for cancer pain management
| Type of intervention or procedure | Primary tumor or metastatic site indications |
|---|---|
| Nerve blocks | |
| Peripheral nerves | |
| Paravertebral ........................................................ | Chest-wall pain after mastectomy |
| Interscalene ......................................................... | Upper-extremity pain after surgical repair of pathologic fractures and neuropathy from brachial plexoplathy |
| Plexus nerves | |
| Celiac ................................................................... | Right-upper-quadrant and epigastric pain from pancreaticobiliary malignancies |
| Superior hypogastric ............................................ | Pelvic pain from gynecologic and urologic malignancies |
| Ganglion impar .................................................... | Perineal and rectal pain from anorectal and vulvar malignancies |
| Implantable catheters and neuromodulation | |
| Intraspinal drug delivery | Visceral pain from abdominal malignancies, neuropathic pain for lower extremities, and intractable back pain from metastases |
| Spinal cord stimulation | |
| Dorsal root ganglion stimulation | |
| Vertebral augmentation | |
| Vertebroplasty | Back pain from spine metastases and vertebral fractures |
| Kyphoplasty | |
| Ablation procedures | |
| Radiofrequency ablation | Pain from metastatic bone and soft-tissues sites |
| Cryoablation | |
| Microwave ablation | |
| Magnetic resonance imaging-guided focused-ultrasound surgery | |
| Transarterial embolization .................................. | Pain from hypervascular bone metastases |