Spinal cord compression in a patient with a pain pump for failed back syndrome: a chalk-like precipitate mimicking a spinal cord neoplasm: case report.
OBJECTIVE
The use of intrathecal morphine has been effective with few complications for chronic intractable pain of both benign and malignant origins. A rare but serious problem that exists is the formation of an inflammatory mass at the catheter tip of the pain pump.


METHODS
We report the case of a 67-year-old female patient with failed back syndrome who presented with sensory complaints and back pain.


METHODS
Magnetic resonance imaging revealed impingement on the thoracic cord by a mass. The mass was originally thought to be a spinal cord tumor; however, operation and chemical analysis of the mass showed that it was a bupivacaine precipitate at the tip of the catheter of the pain pump.


CONCLUSIONS
This is the first such case, to our knowledge, of a bupivacaine precipitate mimicking a spinal cord tumor.
Wadhwa
Rishi K
RK
Department of Neurosurgery, Louisiana State University, Health Sciences Center, Shreveport 71130-3932, USA.
Shaya
Mark R
MR
Nanda
Anil
A
D000368:Aged; D001416:Back Pain / Q000000981:diagnostic imaging / Q000188:drug therapy; D002045:Bupivacaine / Q000008:administration & dosage; D002119:Calcium Carbonate; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000009:adverse effects*; D011859:Radiography; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging* / Q000188:drug therapy; D013120:Spinal Cord Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D013577:Syndrome; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging* / Q000187:drug effects
D002119:Calcium Carbonate; D002045:Bupivacaine