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Spinal neurolysis for cancer pain: indications and recent results.

Effective control of cancer pain can now be achieved in a high proportion of patients with rigorously applied pharmacologic treatment, reducing the need for more demanding invasive procedures. Ten to thirty percent of patients will, however, require some form of more aggressive management, ranging from the parenteral and spinal administration of opioids to neurodestructive procedures. Intrathecal neurolysis is a time-tested procedure that, although used less frequently than in the past, still has important indications. Guidelines for patient selection and results of a recent clinical series are presented here.