title: Phantom Radiculopathy: Case Report and Review of the Literature.
abstract: BACKGROUND
  Phantom radicular pain is very uncommon. To the best of our knowledge, only 14 cases have been described in the literature. A review of the literature revealed the most common cause of phantom radicular pain to be lumbar disc herniation and, furthermore, that treatment with epidural steroid injection or surgical decompression relieves pain in almost all cases. A significant number of patients with superimposed phantom radiculopathy may be missed because of the high incidence of degenerative lumbar spine diseases in the adult population, as well as the fact that amputee patients very often present with mixed stump and phantom pain.
  
  
  METHODS
  We report a case of a patient presenting with new-onset phantom radicular pain (S1 left) 4 years after an above-the-knee amputation (left). Computed tomography myelography showed compression of the left S1 nerve root caused by recurrent disc herniation and scar tissue formation after previous discectomy at L5-S1. The patient experienced temporarily relief of the sciatic pain after a fluoroscopically-guided epidural transforaminal steroid injection. Subsequent microsurgical decompression led to complete remission of the phantom radicular pain.
  
  
  CONCLUSIONS
  Amputees experiencing recurrent phantom radicular pain or new-onset superimposed pain deserve further radiologic evaluation.
authors.affiliation: Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland. Electronic address: neurosurgery@ksa.ch.
authors.forename: Davide
authors.initials: D
authors.lastname: Croci
authors.affiliation: Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland.
authors.forename: Javier
authors.initials: J
authors.lastname: Fandino
authors.affiliation: Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland.
authors.forename: Serge
authors.initials: S
authors.lastname: Marbacher
mesh_terms: D000671:Amputation, Surgical / Q000009:adverse effects*; D019299:Decompression, Surgical / Q000379:methods; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D010591:Phantom Limb / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D011843:Radiculopathy / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D013127:Spinal Nerves / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*
keywords: Amputation; CT myelography; Lumbar disc herniation; Phantom radicular pain; Phantom radiculopathy; Radiologic imaging