Maeda Takuma, Agari Takashi, Komori Takashi, Takai Keisuke
Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.
Laboratory Medicine and Pathology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.
NMC Case Rep J. 2024 Oct 11;11:273-278. doi: 10.2176/jns-nmc.2024-0106. eCollection 2024.
A 59-year-old woman, after surgery for cubital tunnel syndrome, developed complex regional pain syndrome in her right upper limb. Spinal cord stimulation (SCS) electrodes were placed at the C2-C5 level. A conventional low-frequency tonic stimulation was carried out, which attenuated pain. However, 4 years later, left-sided motor weakness and tolerance to SCS therapy occurred. Magnetic resonance imaging revealed epidural granulation tissue around the electrodes that severely compressed the cervical cord. We surgically removed the granuloma, which attenuated motor weakness. A histological examination showed that an allergic reaction to platinum or the insulator appeared responsible for fibrosis.
一名59岁女性在接受尺神经沟综合征手术后,右上肢出现了复杂性区域疼痛综合征。脊髓刺激(SCS)电极被放置在C2 - C5水平。进行了常规的低频强直刺激,疼痛得到缓解。然而,4年后,出现了左侧运动无力以及对SCS治疗的耐受性问题。磁共振成像显示电极周围有硬膜外肉芽组织,严重压迫颈髓。我们通过手术切除了肉芽肿,运动无力症状得到缓解。组织学检查表明,对铂或绝缘体的过敏反应似乎是纤维化的原因。