Schatmeyer Bryan A, Dodin Rakan, Kinsman Michael, Garcia David
1Department of Neurosurgery, University of Kansas Medical Center, Kansas City, Kansas; and.
2Department of Neurosurgery, Children's Mercy Medical Center, Kansas City, Missouri.
J Neurosurg Case Lessons. 2022 Aug 8;4(6). doi: 10.3171/CASE22226.
Central neuropathic pain (CNP) of the cervical and/or thoracic spinal cord has many etiologies, both natural and iatrogenic. Frequently, CNP is medically refractory and requires surgical treatment to modulate the perception of pain. Spinal cord stimulation is a modality commonly used in adults to treat this type of refractory pain; however, it is rarely used in the pediatric population.
The authors reported a case involving a common pediatric condition, Chiari malformation type I with syrinx, that led to a debilitating complex regional pain syndrome. The associated life-altering pain was successfully alleviated following placement of a spinal cord stimulator.
CNP, or the syndromic manifestations of the pain (complex regional pain syndrome), can alter an individual's life in dramatic ways. Spinal cord stimulator placement in carefully selected pediatric patients should be considered in these difficult pain treatment paradigms.
颈段和/或胸段脊髓的中枢性神经病理性疼痛（CNP）有多种病因，包括自然病因和医源性病因。通常，CNP药物治疗无效，需要手术治疗来调节疼痛感知。脊髓刺激是成人常用的治疗此类难治性疼痛的方法；然而，在儿科人群中很少使用。
作者报告了一例涉及常见儿科疾病——I型Chiari畸形伴脊髓空洞症的病例，该病例导致了使人衰弱的复杂性区域疼痛综合征。在植入脊髓刺激器后，相关的改变生活的疼痛得到了成功缓解。
CNP或疼痛的综合征表现（复杂性区域疼痛综合征）会以显著方式改变个体的生活。在这些困难的疼痛治疗模式中，应考虑为精心挑选的儿科患者植入脊髓刺激器。
