Surgical relief of causalgia with an artificial nerve guide tube: Successful surgical treatment of causalgia (Complex Regional Pain Syndrome Type II) by in situ tissue engineering with a polyglycolic acid-collagen tube.
Two patients with causalgia associated with allodynia and finger contracture were treated surgically with a bioresorbable nerve guide tube made from polygycolic acid and collagen: the injured segment of the digital nerve was resected and the resulting gap (25 and 36mm) was bridged with the tube. In both cases, a neuroma was found on the injured nerve and many sprouting branches were. After reconstruction, the causalgia and allodynia disappeared and movement of the fingers recovered during the following 6 months. Functional recovery was objectively identified for 1 year and 9 months. Both patients regained full use of their finger and were free of discomfort for up to 24 and 18 months, respectively. Since the first description of causalgia in 1864, there has been no definitive treatment for this intractable burning pain. Our experience shows that at least some types of causalgia can be resolved successfully by surgery.
Inada
Yuji
Y
Department of Orthopaedic Surgery, Inada Hospital, Nara, Japan Department of Bioartificial Organs, Institute for Frontier Medical Sciences, Kyoto University, 53 Kawahara-cho, Sakyo-Ku Kyoto 606-8507, Japan Department of Neurology, Nara Rehabilitation Center, Nara, Japan Department of Anesthesiology, Ooyodo Hospital, Nara, Japan Kyoto Nerve Regeneration Research Center, Kyoto, Japan.
Morimoto
Shigeru
S
Moroi
Keisichirou
K
Endo
Katsuaki
K
Nakamura
Tatsuo
T
D000328:Adult; D002422:Causalgia / Q000601:surgery*; D003094:Collagen; D005260:Female; D006801:Humans; D008875:Middle Aged; D011100:Polyglycolic Acid; D019919:Prosthesis Implantation / Q000379:methods*; D023822:Tissue Engineering / Q000379:methods*
D011100:Polyglycolic Acid; D003094:Collagen