Intrathecal granuloma after implantation of a morphine pump: Case report and review of the literature

Bejjani, Ghassan K.; Karim, Najmaldin O.; Tzortzidis, Fotios

doi:10.1016/s0090-3019(96)00466-1

Cited by 76 publications

(51 citation statements)

References 20 publications

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“…7,8 The comparative advantages and disadvantages of MRI, CT, and other imaging studies are listed in Table 1. 9,10 Currently, the most sensitive radiologic modality for evaluation of a catheter-tip granuloma, spinal-cord compression, and myelopathic changes within the cord is the MRI.…”

Section: Discussionmentioning

confidence: 99%

New Onset Lumbar Radicular Pain After Implantation of an Intrathecal Drug Delivery System: Imaging Catheter Migration

Ferrante

2006

Regional Anesthesia and Pain Medicine

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Patients with implanted drug delivery systems with positioning of the catheter tip into the lumbar cistern may develop new onset lumbar radicular pain as a result of catheter migration into an intervertebral foramen. Magnetic resonance imaging (MRI) is suggested as the initial imaging study to survey the spine and to evaluate for granuloma formation. Reimaging with computed tomography is essential to follow the course of the catheter and to delineate distal catheter tip location. It is suggested that positioning of the distal catheter tip at a location midway between the superior and inferior articular surfaces of the facet joint may minimize this complication.

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Section: Discussionmentioning

confidence: 99%

New Onset Lumbar Radicular Pain After Implantation of an Intrathecal Drug Delivery System: Imaging Catheter Migration

Ferrante

2006

Regional Anesthesia and Pain Medicine

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“…[54][55][56] Clinicians should be alert for new-onset radicular pain with or without sensory and motor deficits in these patients. Magnetic resonance imaging will demonstrate the mass at the catheter tip.…”

Section: Complicationsmentioning

confidence: 99%

Intrathecal Pumps

2008

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Summary: Direct neuroaxis drug delivery has expanded the physician's armamentarium to provide treatment options to those who have failed more conservative interventions. Starting from Bier's 'cocainization of the spinal cord' in 1898, direct nervous system pharmacy delivery has long been recognized as an effective means to treat pain. Intrathecal pump systems are now commonplace in the management of numerous pain states, as well as of neuromuscular sequelae of central nervous system injury. There has been much advancement in the physiologic and pharmacologic understanding of direct neuromodulation, providing a growing number of treatment options depending on the specific disease state. As well, surgical techniques and catheter systems have undergone refinements providing improved long-term safety and efficacy. We present a review of the historical evolution to current intrathecal therapies, as well as a dialog regarding patient selection, drug options, and side effects. Also, included is a discussion of surgical techniques, current delivery options and complications concerning pump placement.

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“…Indikationen für die Anwendung einer rückenmarknahen Verabreichung von Analgetika stellen maligne [1,3,15,17,19,23,24,25,32,34] und nichtmaligne [1,14,15,17,20,22,27,30,33,34] chronische Erkrankungen dar.…”

Section: Stellenwertunclassified

Importance of intrathecal pain therapy

Likar

Ilias

Kloimstein

et al. 2007

Schmerz

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Intraspinal drug infusion using implantable pumps and catheter systems is a safe and effective therapy for selected pain patients with severe chronic pain. It improves pain relief, reduces drug-related side effects, decreases the need for oral analgesia and enhances quality of life in a segment of chronic pain patients whose pain has not been controlled with more conservative therapies. Intrathecal drug therapy has therefore established its role in the treatment of malignant pain, benign pain and severe spasticity.Careful patient selection and management as well as a multidisciplinary approach are determinants of successful treatment. Current practices for patient selection and management, screening, drug selection, dosing and implantation for intrathecal drug delivery systems are discussed.

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Intrathecal granuloma after implantation of a morphine pump: Case report and review of the literature

Cited by 76 publications

References 20 publications

New Onset Lumbar Radicular Pain After Implantation of an Intrathecal Drug Delivery System: Imaging Catheter Migration

New Onset Lumbar Radicular Pain After Implantation of an Intrathecal Drug Delivery System: Imaging Catheter Migration

Intrathecal Pumps

Importance of intrathecal pain therapy

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