Goff Brandon Jesse, Naber Jeremy Wingseng, McCallin John Patrick, Lopez Edward Michael, Guthmiller Kevin Brant, Lautenschlager Karl Alan, Lai Tristan Toll, Hommer Dean Harry, Marin Gonzalez Raul
San Antonio Military Medical Center, San Antonio, TX 78234, USA.
Philadelphia College of Osteopathic Medicine, Philadelphia, PA 19128, USA.
Case Rep Anesthesiol. 2014;2014:784021. doi: 10.1155/2014/784021. Epub 2014 Nov 24.
Complex regional pain syndrome (CRPS) is a neuropathic pain condition that is characterized by vasomotor, sensory, sudomotor, and motor symptoms. Spinal cord stimulation (SCS) has been successfully utilized for the treatment of pain refractory to conventional therapies. We present a case of a previously highly functioning 54-year-old female who developed a rarely reported case of idiopathic CRPS of the right ankle which spontaneously occurred four months after an uncomplicated anterior cervical disc fusion. This condition resulted in severe pain and functional impairment that was unresponsive to pharmacological management. The patient's rehabilitation was severely stymied by her excruciating pain. However, with the initiation of spinal cord stimulation, her pain was adequately controlled allowing for progression to full unassisted ambulation, advancing functional capacity, and improving quality of life. This case report supports the concept that rapid progression to neuromodulation, rather than delays that occur due to attempts at serial sympathetic blocks, may better control symptoms leading allowing for a more meaningful recovery.
复杂性区域疼痛综合征(CRPS)是一种神经性疼痛疾病,其特征为血管运动、感觉、汗腺分泌和运动症状。脊髓刺激(SCS)已成功用于治疗对传统疗法难治的疼痛。我们报告一例病例,一名54岁既往功能良好的女性,发生了罕见的右踝特发性CRPS,在无并发症的前路颈椎间盘融合术后四个月自发出现。这种情况导致严重疼痛和功能障碍,对药物治疗无反应。患者的康复因极度疼痛而严重受阻。然而,随着脊髓刺激的开始,她的疼痛得到了充分控制,能够进展到完全独立行走,提高功能能力,并改善生活质量。本病例报告支持这样的观点,即快速进展到神经调节,而不是由于尝试进行系列交感神经阻滞而导致的延迟,可能更好地控制症状,从而实现更有意义的康复。