Bejjani G K, Karim N O, Tzortzidis F
Department of Neurosurgery, George Washington University, Washington, DC 20037, USA.
Surg Neurol. 1997 Sep;48(3):288-91. doi: 10.1016/s0090-3019(96)00466-1.
Intrathecal morphine pumps are being increasingly used in patients with benign pain who have a longer life expectancy than cancer patients. Newer complications may be encountered.
We report a complication that occurred in a 48-year-old woman who presented with intractable lower back pain 18 months after morphine pump implantation. Magnetic resonance imaging of the lumbosacral spine revealed an intrathecal mass around the catheter. At surgery, an inflammatory mass was found without any evidence of neoplasia or infection. This is a very unusual complication of intrathecal morphine pumps. (Related animal and human studies are reviewed in this article.)
Long-term use of implantable pumps may carry increased risks that are not observed during the short-term experience of cancer patients. Reimaging is important in evaluating patients who have developed uncontrollable pain and new neurologic findings.
鞘内吗啡泵越来越多地用于预期寿命比癌症患者更长的良性疼痛患者。可能会出现新的并发症。
我们报告了一名48岁女性出现的并发症，该患者在吗啡泵植入18个月后出现顽固性下背痛。腰骶部脊柱磁共振成像显示导管周围有一个鞘内肿块。手术时，发现一个炎性肿块，没有任何肿瘤或感染的迹象。这是鞘内吗啡泵非常罕见的并发症。（本文对相关动物和人体研究进行了综述。）
长期使用植入式泵可能会带来更高的风险，而这在癌症患者的短期治疗中并未观察到。对于出现无法控制的疼痛和新的神经学表现的患者，再次成像评估很重要。
