Chest wall pain due to tumor invasion or somatic
and neural structures can also be treated with
rhizotomy, the segmental or multi-segmental
destruction of the dorsal sensory roots. Rhizotomy
is achieved by surgical section, chemical neurolysis,
or radiofrequency ablation and can be an effective
method of pain control with refractory localized
pain syndromes. Chemical rhizotomy produced by
the instillation of a neurolytic solution (eg, phenol)
into either the epidural or intrathecal space can be
performed at any level up to the mid-cervical regions,
above which the spread of neurolytic agent to the
medullary centre carries an unacceptable risk of
cardio respiratory collapse