Saulino M
Moss Rehab., Department of Rehabilitation Medicine, Thomas Jefferson University, Elkins Park, PA, USA.
Spinal Cord. 2007 Nov;45(11):749-52. doi: 10.1038/sj.sc.3102027. Epub 2007 Feb 20.
Case report.
To report a novel management strategy for neuropathic pain management after spinal cord injury.
Outpatient spinal cord injury (SCI) clinic.
The patient demonstrated two neuropathic pain syndromes, namely at- and below-level pain. These syndromes were recalcitrant to conservative measures and a decision was made to proceed with intrathecal therapies.
The patient's at-level pain was responsive to intrathecal hydromorphone but the below-level pain was unaffected by this intervention. Intrathecal ziconotide provided an opposite response with a positive effect observed on the below-level pain and minimal effect on the at-level pain. The combination of intrathecal ziconotide and hydromorphone provided effective relief for both components of the patient's SCI associated neuropathic pain.
The combination of intrathecal ziconotide and hydromorphone has the potential to provide significant pain relief for patients with neuropathic pain associated with spinal cord injury.
病例报告。
报告一种脊髓损伤后神经性疼痛管理的新策略。
门诊脊髓损伤（SCI）诊所。
该患者表现出两种神经性疼痛综合征，即损伤平面及以上疼痛和损伤平面以下疼痛。这些综合征对保守治疗无效，因此决定采用鞘内治疗。
患者的损伤平面及以上疼痛对鞘内注射氢吗啡酮有反应，但损伤平面以下疼痛不受该干预影响。鞘内注射齐考诺肽产生了相反的效果，对损伤平面以下疼痛有积极作用，对损伤平面及以上疼痛影响极小。鞘内注射齐考诺肽和氢吗啡酮的联合使用为该患者脊髓损伤相关神经性疼痛的两个组成部分都提供了有效缓解。
鞘内注射齐考诺肽和氢吗啡酮联合使用有可能为脊髓损伤相关神经性疼痛患者提供显著的疼痛缓解。
