Diabetic thoracic radiculopathy: an unusual cause of post-thoracotomy pain.
Persistent pain is common following thoracotomy. A 64-year-old retired electrician with Type 2 diabetes presented with chest wall and abdominal pain 3 months following video-assisted thoracoscopic surgery (VATS). Postoperatively the patient had suffered pain despite a functioning thoracic epidural catheter. Following investigation, his persistent pain was due to diabetic thoracic radiculopathy (DTR). The disorder is characterized by pain, sensory loss, abdominal and thoracic muscle weakness in patients with diabetes. As in this patient, the pain and sensory loss usually resolve within one year after onset. The disorder may be distinguished from intercostal neuralgia based upon clinical and electromyographic features.
Department of Anesthesiology, Neurology, Neuroscience, Duke University Medical Center, Durham, NC 27710, USA. brewe019@mc.duke.edu
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Brewer
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Bedlack
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Massey
D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004576:Electromyography / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000503:physiopathology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology*; D011843:Radiculopathy / Q000503:physiopathology / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D013907:Thoracostomy / Q000009:adverse effects*