[Spinal granuloma in a patient receiving a spinal infusion of morphine and clonidine].
Patients treated with long-term spinal infusion of high doses of morphine develop a granuloma at the location of the catheter tip. Diagnosis is based on a steady increase in intrathecal morphine dosage after a relatively prolonged period of stability, on the gradual development of neurologic signs and symptoms suggesting radicular or spinal cord compression, and on magnetic resonance images. We describe a man with central neuropathic pain after removal of a tumor. The presence of all 3 of the aforementioned diagnostic criteria led to suspicion of a spinal granuloma.
Abejón
D
D
Unidad del Dolor, Hospital Universitario Puerta de Hierro, Madrid. dabejon@telefonica.net
del Saz
J M
JM
Ley
L
L
Sánchez
M R
MR
del Pozo
C
C
D015360:Analgesia, Epidural / Q000295:instrumentation*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D001416:Back Pain / Q000209:etiology*; D002404:Catheterization / Q000009:adverse effects*; D003000:Clonidine / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004630:Emergencies; D015745:Granuloma, Foreign-Body / Q000209:etiology* / Q000601:surgery; D020786:Hemangioma, Cavernous, Central Nervous System / Q000601:surgery; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000009:adverse effects*; D007263:Infusions, Parenteral / Q000295:instrumentation; D007796:Laminectomy; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use*; D009125:Muscle Relaxants, Central / Q000008:administration & dosage / Q000627:therapeutic use*; D009437:Neuralgia / Q000209:etiology*; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D013117:Spinal Cord Compression / Q000209:etiology* / Q000601:surgery; D013118:Spinal Cord Diseases / Q000601:surgery
D000701:Analgesics, Opioid; D009125:Muscle Relaxants, Central; D009020:Morphine; D003000:Clonidine