Hypothesis about the etiology of unexplained painful myelopathy after minor trauma in the spinal canal.
After electrode insertion for epidural spinal cord stimulation, of 625 electrode operations, unexplained, temporary paralysis resulted in 1.8%, and multidermatomal, painful allodynia in 4.2% (of whom 19% had also had temporary paralysis). Diagnostic testing yielded no anatomical explanation. In patients who were awake during operation, these deficits were noted to begin immediately after pain caused by mechanical deformation of the dura. The author hypothesized the following: myelopathy may result from cord ischemia, caused by vasospasm, triggered by pain within or near the spinal canal. The author proposes to prevent these complications by selective epidural anesthesia.
Colorado Neurological Institute, Englewood, USA.
J D
JD
Law
D004558:Electric Stimulation / Q000009:adverse effects; D004566:Electrodes / Q000009:adverse effects; D006801:Humans; D006941:Hyperesthesia / Q000209:etiology; D008959:Models, Neurological; D010146:Pain; D010243:Paralysis / Q000209:etiology; D013115:Spinal Canal / Q000293:injuries*; D013118:Spinal Cord Diseases / Q000209:etiology* / Q000503:physiopathology*; D014947:Wounds and Injuries / Q000150:complications*