Case Report
Spinal Cord (2008) 46, 82–84; doi:10.1038/sj.sc.3102074; published online 31 July 2007
Complex regional pain syndrome in a patient with spinal cord injury: management with pulsed radiofrequency lumbar sympatholysis
Y Akkoc1, M Uyar2, J Oncu1, Z Ozcan3 and B Durmaz1
- 1Department of Physical Medicine and Rehabilitation, Medical Faculty of Ege University, Bornova-IZMIR, Turkey
- 2Division of Algology, Department of Anaesthesiology, Medical Faculty of Ege University, Bornova-IZMIR, Turkey
- 3Department of Nuclear Medicine, Medical Faculty of Ege University, Bornova-IZMIR, Turkey
Correspondence: Professor Dr Y Akkoc, Ege Universitesi Tip Fakultesi, Fiziksel Tip ve Rehabilitasyon Anabilim Dali, Bornova-IZMIR, Turkey. E-mail: yesim.akkoc@ege.edu.tr
Received 17 July 2006; Revised 29 March 2007; Accepted 1 April 2007; Published online 31 July 2007.
Abstract
Study design:
Short communication.
Objectives:
To report a case with bilateral lower extremity complex regional pain syndrome (CRPS) in a patient with paraplegia occurring following spinal disc herniation surgery, who was treated successfully with pulse radiofrequency (PRF) lumbar sympatholysis.
Setting:
Departments of Physical Medicine and Rehabilitation, Algology Department of Anaesthesiology and Nuclear Medicine, Medical Faculty of Ege University, Izmir, Turkey.
Methods:
A 55-year-old woman had neuropathic pain in her lower extremities after T12–L1 disc herniation surgery. The pain decreased to a tolerable level with conservative treatment and her condition remained stable for the following 6 months; then she developed swelling, redness and severe burning pain in both feet. Physical examination showed edema and redness in the feet. On the basis of clinical findings and Tc-99m methylene diphosphonate (MDP) three-phase bone scintigraphy, she was diagnosed to have CRPS.
Results:
The patient underwent a diagnostic sympathetic ganglion blockade with bupivacaine, which resulted in a marked decrease in the pain and edema of the feet. Consequently, PRF lumbar sympatholysis was performed with a successful outcome in pain, edema and color changes in the feet.
Conclusion:
When treatment of CRPS fails with conventional modalities, PRF sympatholysis may be used for control of pain and other symptoms in such patients.
Keywords:
complex regional pain syndrome, paraplegia, radiofrequency lumbar sympatholysis
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