title: Immediate Return to Ambulation and Improved Functional Capacity for Rehabilitation in Complex Regional Pain Syndrome following Early Implantation of a Spinal Cord Stimulation System.
abstract: Complex regional pain syndrome (CRPS) is a neuropathic pain condition that is characterized by vasomotor, sensory, sudomotor, and motor symptoms. Spinal cord stimulation (SCS) has been successfully utilized for the treatment of pain refractory to conventional therapies. We present a case of a previously highly functioning 54-year-old female who developed a rarely reported case of idiopathic CRPS of the right ankle which spontaneously occurred four months after an uncomplicated anterior cervical disc fusion. This condition resulted in severe pain and functional impairment that was unresponsive to pharmacological management. The patient's rehabilitation was severely stymied by her excruciating pain. However, with the initiation of spinal cord stimulation, her pain was adequately controlled allowing for progression to full unassisted ambulation, advancing functional capacity, and improving quality of life. This case report supports the concept that rapid progression to neuromodulation, rather than delays that occur due to attempts at serial sympathetic blocks, may better control symptoms leading allowing for a more meaningful recovery.
authors.affiliation: San Antonio Military Medical Center, San Antonio, TX 78234, USA.
authors.forename: Brandon Jesse
authors.initials: BJ
authors.lastname: Goff
authors.affiliation: Philadelphia College of Osteopathic Medicine, Philadelphia, PA 19128, USA.
authors.forename: Jeremy Wingseng
authors.initials: JW
authors.lastname: Naber
authors.affiliation: San Antonio Military Medical Center, San Antonio, TX 78234, USA.
authors.forename: John Patrick
authors.initials: JP
authors.lastname: McCallin
authors.affiliation: San Antonio Military Medical Center, San Antonio, TX 78234, USA.
authors.forename: Edward Michael
authors.initials: EM
authors.lastname: Lopez
authors.affiliation: San Antonio Military Medical Center, San Antonio, TX 78234, USA.
authors.forename: Kevin Brant
authors.initials: KB
authors.lastname: Guthmiller
authors.affiliation: San Antonio Military Medical Center, San Antonio, TX 78234, USA.
authors.forename: Karl Alan
authors.initials: KA
authors.lastname: Lautenschlager
authors.affiliation: San Antonio Military Medical Center, San Antonio, TX 78234, USA.
authors.forename: Tristan Toll
authors.initials: TT
authors.lastname: Lai
authors.affiliation: San Antonio Military Medical Center, San Antonio, TX 78234, USA.
authors.forename: Dean Harry
authors.initials: DH
authors.lastname: Hommer
authors.affiliation: San Antonio Military Medical Center, San Antonio, TX 78234, USA.
authors.forename: Gonzalez Raul
authors.initials: GR
authors.lastname: Marin