title: [Spinal granuloma in a patient receiving a spinal infusion of morphine and clonidine].
abstract: 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.
authors.affiliation: Unidad del Dolor, Hospital Universitario Puerta de Hierro, Madrid. dabejon@telefonica.net
authors.forename: D
authors.initials: D
authors.lastname: Abejón
authors.forename: J M
authors.initials: JM
authors.lastname: del Saz
authors.forename: L
authors.initials: L
authors.lastname: Ley
authors.forename: M R
authors.initials: MR
authors.lastname: Sánchez
authors.forename: C
authors.initials: C
authors.lastname: del Pozo
mesh_terms: 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
chemical_list: D000701:Analgesics, Opioid; D009125:Muscle Relaxants, Central; D009020:Morphine; D003000:Clonidine