The Anaesthesia, Critical Care and Multidisciplinary Pain Management Department, General University Hospital, Valencia, Spain.
Clin J Pain. 2010 Sep;26(7):631-4. doi: 10.1097/AJP.0b013e3181e4a541.
Intrathecal granuloma associated to the tip of catheters implanted in patients receiving long-term spinal infusion to alleviate chronic pain is a rare but potentially catastrophic complication. Its formation seems to be related to the intrathecal administration of opioid drugs, although not all opioids induce granuloma formation with the same frequency.
In this clinical report, we describe an intrathecal granuloma that reoccur twice in the same patient after its surgical removal.
This case report highlights the incomplete knowledge about the mechanism of granuloma formation and discuss the alternatives in the management of catheter-tip granulomas. This is the first case report of a patient in whom an intrathecal granuloma reoccurred twice after initial surgical removal. We also present and discuss a potential management strategy to avoid further surgery and resume intrathecal therapy early.
与长期接受脊髓输注以缓解慢性疼痛的患者植入的导管尖端相关的鞘内肉芽肿是一种罕见但潜在灾难性的并发症。其形成似乎与鞘内给予阿片类药物有关，尽管并非所有阿片类药物都会以相同的频率引起肉芽肿形成。
在本临床报告中，我们描述了一名患者在两次手术切除后再次发生鞘内肉芽肿的情况。
本病例报告强调了对肉芽肿形成机制的不完全了解，并讨论了导管尖端肉芽肿处理的替代方案。这是首例在初次手术切除后鞘内肉芽肿再次发生的病例报告。我们还提出并讨论了一种潜在的管理策略，以避免进一步手术并尽早恢复鞘内治疗。
