Institute of Pain Management, P.A., Jacksonville, Florida 32257, USA.
Pain Pract. 2010 Jan-Feb;10(1):78-83. doi: 10.1111/j.1533-2500.2009.00321.x. Epub 2009 Oct 26.
Complex regional pain syndrome is a condition that usually affects the upper or lower extremities. The cause is not clearly understood. We report a case of a severe form of a rapidly progressive complex regional pain syndrome type I developing after a right shoulder injury managed with spinal cord stimulation (SCS). After failed conservative treatments, a rechargeable SCS system was implanted in the cervical spine. Allodynia and dystonia improved but the patient subsequently developed similar symptoms in lower right extremity followed by her lower left extremity. The patient became wheelchair bound. A second rechargeable SCS with a paddle electrode was implanted for the lower extremity coverage. The patient's allodynia and skin lesions improved significantly. However, over time, her initial symptoms reappeared which included skin breakdown. Due to the need for frequent recharging, the system was removed. During explantation of the surgical paddle lead, it was noted by the neurosurgeon that the contacts of the paddle lead were detached from the lead. After successful implantation of another SCS system, the patient was able to reduce her medications and is now able to ambulate with the use of a left elbow crutch.
复杂性区域疼痛综合征通常影响上肢或下肢。其病因尚不清楚。我们报告了一例严重的快速进展性 I 型复杂性区域疼痛综合征，该综合征发生于右肩部损伤后，采用脊髓刺激（SCS）治疗。在保守治疗失败后，在颈部植入了可充电 SCS 系统。感觉异常和运动障碍得到改善，但随后患者右下肢体和左下肢体出现类似症状。患者需要坐轮椅。为了覆盖下肢，又植入了第二个带有桨状电极的可充电 SCS。患者的感觉异常和皮肤损伤明显改善。然而，随着时间的推移，她最初的症状再次出现，包括皮肤破损。由于需要频繁充电，因此将系统移除。在取出外科桨状电极的过程中，神经外科医生注意到桨状电极的电极与电极线脱离。在另一个 SCS 系统成功植入后，患者能够减少药物用量，现在可以使用左肘拐杖行走。
