Goto Shinichi, Taira Takaomi, Hori Tomokatsu
Department of Neurosurgery, Tokyo Women's Medical University, Tokyo 162-8666.
Masui. 2009 Sep;58(9):1158-61.
The authors describe an experience of spinal cord stimulation (SCS) in a 30-year-old woman who developed complex regional pain syndrome type-I (CRPS-I) with spread phenomenon. She had received lumbar SCS under a diagnosis of CRPS-I in her left leg for 8 years. She had refractory pain in her right arm for the recent two years. There was no new lesion explaining her refractory pain on physical or radiological examination. Thus, the pain in her right upper arm was considered as spread phenomenon of CRPS-I. Test stimulation with cervical epidural spinal electrode showed good results and the pulse generator was implanted. It is suggested that the symptom of CRPS-I involving spread phenomenon was possibly due to a cortical reorganization. But a certain effect of SCS may be contributing to the favorable results of test stimulation for the treatment of CRPS-I with spread phenomenon in this case.
作者描述了一名30岁女性脊髓刺激（SCS）的经历，该女性患有一种伴有扩散现象的I型复杂性区域疼痛综合征（CRPS-I）。她因左腿CRPS-I诊断接受了8年的腰部SCS治疗。近两年她右臂出现顽固性疼痛。体格检查和影像学检查均未发现新的病变来解释她的顽固性疼痛。因此，她右上臂的疼痛被认为是CRPS-I的扩散现象。颈段硬膜外脊髓电极测试刺激显示效果良好，遂植入了脉冲发生器。提示CRPS-I伴有扩散现象的症状可能是由于皮质重组。但在这种情况下，SCS的一定作用可能有助于测试刺激对伴有扩散现象的CRPS-I治疗取得良好效果。
