The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Pain Control by Spinal Cord Stimulation in the Reflex Sympathetic Dystrophy -A case report-

반사성 교감신경성 위축증 환자에서 척수 자극기를 이용한 통증관리 -증례 보고-

  • Lee, Sang-Chul (Department of anesthesiology, College of medicine, Seoul National University) ;
  • Kim, Jin-Hee (Department of anesthesiology, College of medicine, Seoul National University) ;
  • Hwang, Jung-Won (Department of anesthesiology, College of medicine, Seoul National University) ;
  • Han, Mi-Ae (Department of anesthesiology, College of medicine, Seoul National University) ;
  • Kim, Seong-Deok (Department of anesthesiology, College of medicine, Seoul National University) ;
  • Kim, Kye-Min (Department of anesthesiology, College of medicine, Seoul National University) ;
  • Lee, Byeong-Geon (Department of anesthesiology, College of medicine, Seoul National University)
  • 이상철 (서울대학교 의과대학 마취과학교실) ;
  • 김진희 (서울대학교 의과대학 마취과학교실) ;
  • 황정원 (서울대학교 의과대학 마취과학교실) ;
  • 한미애 (서울대학교 의과대학 마취과학교실) ;
  • 김성덕 (서울대학교 의과대학 마취과학교실) ;
  • 김계민 (서울대학교 의과대학 마취과학교실) ;
  • 이병건 (서울대학교 의과대학 마취과학교실)
  • Published : 1997.05.31
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Abstract

Regional sympathetic blockade is the most effective treatment for reflex sympathetic dystrophy (RSD). Radiofrequency thermocoagulation provides longer duration of pain relief than local anesthetics and less complication than chemical neurolytic agents for lumbar sympathectomy. Spinal cord stimulation (SCS) is thought to be an effective modality yieding good results in treating intractable neuropathic pain. Therefore RSD might be a good indication for SCS. We treated a patient with RSD who responded well to lumbar sympathetic blockade (LSB) with radiofrequency thermocoagulation and SCS. The patient had a left ankle sprain requiring a case for the lower leg for 2 weeks. The patient suffered increasing pain and swelling on the lower part of that leg. We thought to block the lumbar sympathetic chain utillzing radiofrequency thermocoagulation 2 days after LSB with local anesthetics. The results provided accepatable pain relief (VAS $8{\rightarrow}15$) but the patient still could not walk due to remaining pain which was further aggravated by walking. After SCS, pain relief improved (VAS $5{\rightarrow}13$) and patient could walk without assistance.

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