Sciatica presenting as post-amputation neuroma: presentation and clinical findings

Mofidi, A.; Kotecha, Amit; Banerjee, Robin; Rao, Chandra; Trivedi, Jayesh

doi:10.1007/s00590-009-0488-9

Cited by 3 publications

(4 citation statements)

References 14 publications

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“…Andrzej C. Kroszczynski, MD 1 , Kevin Kohan, DO 1 Discussion/Conclusions: We found only one anterior radiculomedullary artery directly anastomosed with the ASA from T2 to S4 and it exhibited the characteristic hairpin turn just prior to joining the ASA. Thus, by convention, we called it the AKA.…”

Section: Left S2 Adamkiewicz Artery: a Case Studymentioning

confidence: 75%

“…The conclusion will summarize and assess the study findings.12. Pulsed Radiofrequency on L2 Dorsal Root Ganglion as a Therapeutic Method for Lumbar Discogenic Pain: One Year Follow-up Study Involving 26 PatientsFabricio Dias Assis, MD 1 , Charles Amaral de Oliveira, MD 1 , Fabíola Peixoto Minson, MD1,2 , Carlos Tucci, MD1,3 , Jamir Sardá Jr., PhD,1,4 1Singular Pain Clinic, Campinas, SP, Brazil 2Integrated Center for the Treatment of Pain, Albert Einstein Hospital, SP, Brazil 3PUC -Catholic University, Campinas, SP, Brazil 4Vale do Itajaí University, Univali, SC, BrazilChronic low back pain can be defined as pain that lasts beyond 3 months. The high prevalence of this condition in the general population incurs substantial social and economic costs to society.…”

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confidence: 99%

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Abstracts Presented at the American Society of Interventional Pain Physicians 12th Annual Meeting, June 26 and 27, 2010, Arlington, Virginia

Kroszczyński

2010

Pain Phys

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Lower back and extremity pain in the amputee patient can be challenging to classify and treat (1). Both patients and physicians classically find it difficult to discern between phantom sensation, phantom limb pain, and stump pain, and radicular compression is often not considered (2). Case Report: We present a case of phantom radiculitis in a 67-year-old gentleman with new onset 10/10 pain in a phantom extremity superimposed upon a 40-year history of previously stable phantom limb pain. MRI showed a central disc herniation at L4/5 with compression of the traversing left L4 nerve root (Fig. 1). Two fluoroscopically guided left transforaminal epidural steroid injections (one at the level of the L4 and a second at the levels of the L4 and L5 spinal nerve roots) totally alleviated his new onset pain (Fig. 2). At one year post injection, his phantom radiculitis pain was completely gone, though his underlying phantom limb pain remained. Discussion: Lumbar radiculitis in lower extremity amputee patients may be difficult to differentiate from baseline phantom limb pain. When conservative techniques fail, fluoroscopically guided spinal nerve injection may be valuable in determining the etiology of lower extremity pain. Our experience supports the notion that epidural steroid injections can effectively treat lumbar radiculopathy in lower extremity amputees.

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Section: Left S2 Adamkiewicz Artery: a Case Studymentioning

confidence: 75%

mentioning

confidence: 99%

Abstracts Presented at the American Society of Interventional Pain Physicians 12th Annual Meeting, June 26 and 27, 2010, Arlington, Virginia

Kroszczyński

2010

Pain Phys

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“…Under fluoroscopic guidance, a mixture Phantom Radiculitis Treated by Fluoroscopically Guided Transforaminal Epidural Steroid Injections Indeed, in patients lacking the above symptoms, radiculitis may be a more appropriate term. Occasionally, nerve root tension in the opposite leg (crossed straight leg reflex) is positive, and may aid in the diagnosis (4). Literature suggests that this sign may be associated with a herniated lumbar disk in up to 97% of patients with back pain (10).…”

Section: Case Reportmentioning

confidence: 99%

“…As these patients age, their back pain can become complicated as they develop lumbar disc disease (2,3). Radicular compression in a patient with lower limb amputation may present as or be superimposed upon phantom limb pain, creating diagnostic difficulties (4,5). Both patients and physicians classically find it difficult to discern phantom sensation from phantom limb pain and stump pain; radicular compression is often not considered.…”

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confidence: 99%

Phantom Radiculitis Effectively Treated by Fluoroscopically Guided Transforaminal Epidural Steroid Injections

DeGregoris

2010

Pain Phys

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Lower back and extremity pain in the amputee patient can be challenging to classify and treat. Radicular compression in a patient with lower limb amputation may present as or be superimposed upon phantom limb pain, creating diagnostic difficulties. Both patients and physicians classically find it difficult to discern phantom sensation from phantom limb pain and stump pain; radicular compression is often not considered. Many studies have shown back pain to be a significant cause of pain in lower limb amputees, but sciatica has been rarely reported in amputees. We present a case of L4/5 radiculitis in an above-knee amputee presenting as phantom radiculitis. Our patient is a 67 year old gentleman with new onset 10/10 pain in a phantom extremity superimposed upon a 40 year history of previously stable phantom limb pain. MRI showed a central disc herniation at L4/5 with compression of the traversing left L4 nerve root. Two fluoroscopically guided left transforaminal epidural steroid injections at the level of the L4 and L5 spinal nerve roots totally alleviated his new onset pain. At one year post injection, his phantom radiculitis pain was completely gone, though his underlying phantom limb pain remained. Lumbar radiculitis in lower extremity amputee patients may be difficult to differentiate from baseline phantom limb pain. When conservative techniques fail, fluoroscopically guided spinal nerve injection may be valuable in determining the etiology of lower extremity pain. Our experience supports the notion that epidural steroid injections can effectively treat phantom lumbar radiculitis in lower extremity amputees. Key words: amputee, phantom pain, phantom sensation, phantom radiculitis, disc herniation, interlaminar, transforaminal, epidural steroid injection

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Perceptions of low back pain in people with lower limb amputation: a focus group study

Devan

Carman

Hendrick

et al. 2014

Disability and Rehabilitation

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The results suggest "uneven movements" of the back affected by "fatigue" and "prosthesis-related factors" may alter the mechanical loading of the spine during functional activities and contribute to LBP. While being physically active helped participants cope with their LBP, identifying and addressing "uneven movements" in the back during the performance of functional activities may be important to devise prevention strategies for LBP.

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Sciatica presenting as post-amputation neuroma: presentation and clinical findings

Cited by 3 publications

References 14 publications

Abstracts Presented at the American Society of Interventional Pain Physicians 12th Annual Meeting, June 26 and 27, 2010, Arlington, Virginia

Abstracts Presented at the American Society of Interventional Pain Physicians 12th Annual Meeting, June 26 and 27, 2010, Arlington, Virginia

Phantom Radiculitis Effectively Treated by Fluoroscopically Guided Transforaminal Epidural Steroid Injections

Perceptions of low back pain in people with lower limb amputation: a focus group study

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