Intrinsic spinal cord catheter placement: implications of new intractable pain in a patient with a spinal cord injury.
We present a case of new intractable flank pain after intrathecal infusion system placement in a 45-yr-old man with a history of a T12 spinal cord injury with dysesthetic leg pain. Pain after intrathecal infusion system placement was evaluated by magnetic resonance imaging and the catheter was found to be intraparenchymal. The patient was treated by cessation of infusion and surgical removal of the system. Before surgical removal, the pump was turned off and the patient's flank pain resolved. Increased vigilance is warranted when caring for paraplegic patients. When new pain persists, intrathecal medication tapering should be considered.
Huntoon
Marc A
MA
*Department of Anesthesiology, †Mayo Clinic College of Medicine, ‡Department of Neurologic Surgery, and §Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota.
Hurdle
Mark-Friedrich B
MB
Marsh
Richard W
RW
Reeves
Ronald K
RK
D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D002404:Catheterization / Q000009:adverse effects*; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use; D010148:Intractable Pain / Q000188:drug therapy* / Q000209:etiology*; D010264:Paraplegia / Q000150:complications; D013116:Spinal Cord / Q000473:pathology; D013119:Spinal Cord Injuries / Q000150:complications*
D000701:Analgesics, Opioid; D009020:Morphine