title: Amputation as an Unusual Treatment for Therapy-Resistant Complex Regional Pain Syndrome, Type 1.
abstract: BACKGROUND
  Complex regional pain syndrome, type 1 (CRPS-1) causes severe pain that can be resistant to multiple treatment modalities. Amputation as a form of long-term treatment for therapy-resistant CRPS-1 is controversial.
  
  
  METHODS
  We report the case of a 38-year-old man who failed all treatment modalities for CRPS-1, including medication, steroid injections, and spinal cord stimulator implantation. Below-the-knee amputation to relieve intractable foot and ankle pain resulted in a favorable outcome for this patient.
  
  
  CONCLUSIONS
  Select patients with severe CRPS-1 who are unresponsive to all forms of treatment for pain may benefit from amputation as a last option for relief of suffering. Larger studies are needed to prove the efficacy of amputation.
authors.affiliation: Department of Outcomes Research, Cleveland Clinic, Cleveland, OH.
authors.forename: Babak K
authors.initials: BK
authors.lastname: Kashy
authors.affiliation: Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI.
authors.forename: Alaa A
authors.initials: AA
authors.lastname: Abd-Elsayed
authors.affiliation: Department of General Anesthesiology, Cleveland Clinic, Cleveland, OH.
authors.forename: Ehab
authors.initials: E
authors.lastname: Farag
authors.affiliation: Department of General Anesthesiology, Cleveland Clinic, Cleveland, OH.
authors.forename: Maria
authors.initials: M
authors.lastname: Yared
authors.affiliation: Center for Regional Neurosciences, Cleveland Clinic, Cleveland, OH.
authors.forename: Roya
authors.initials: R
authors.lastname: Vakili
authors.affiliation: Department of General Anesthesiology, Cleveland Clinic, Cleveland, OH.
authors.forename: Wael Ali Sakr
authors.initials: WA
authors.lastname: Esa
keywords: Amputation; complex regional pain syndrome–type 1; reflex sympathetic dystrophy