[Management of pain from osteoporotic vertebral fractures with continuous intrathecal administration of morphine].
Vertebral fractures are the most common consequences of severe osteoporosis. The chronic pain from collapse of osteoporotic vertebrae affects quality of life and autonomy of patients. The management of pain with oral or transdermal opiates can cause severe side-effects. Continuous intrathecal administration of morphine with an implantable pump represents a good alternative therapy and has advantages in pain relief and quality of life.


METHODS
We report our experience in the treatment of refractory chronic pain due to vertebral fractures using pumps for intrathecal infusion of morphine in 24 patients. We administered the Visual Analogue Scale (VAS) and the Quality of Life Questionnaire of the European Foundation of Osteoporosis (QUALEFFO).


RESULTS
A significant pain relief was obtained in all implanted patients. Using the QUALEFFO we observed significant improvements of all variables such as QDL (quality of life), DW (domestic work), ambulation and PHS (perception of health status), before and after 1 year from pump implantation. With intrathecal morphine infusion none of the patients required additional systemic analgesics.


CONCLUSIONS
Our results show that intrathecal administration of morphine efficiently relieves the symptoms of pain and improve the quality of life. Continuous intrathecal administration of morphine represents a good alternative therapy and has advantages in those patients who suffer from severe side-effects with systemic administration.
Piva
Bruno
B
Servizio di Terapia del dolore e Cure palliative, Azienda ULSS 18, Rovigo.
Shaladi
Ali
A
Crestani
Francesco
F
Saltari
Rita
R
Micheletto
Giuseppe
G
Pinato
Gianpaolo
G
D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal / Q000379:methods; D008297:Male; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use*; D010024:Osteoporosis / Q000150:complications*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology* / Q000523:psychology; D010147:Pain Measurement; D011788:Quality of Life; D016103:Spinal Fractures / Q000150:complications* / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires
D000701:Analgesics, Opioid; D009020:Morphine