Abstract：
BACKGROUND:This case report identifies a patient with complex regional pain syndrome Type 2 (causalgia) with sympathetically maintained pain in a distal extremity associated with an anterior sacroiliac fusion with local bone graft. CASE DESCRIPTION:A sacroiliac fusion was undertaken due to chronic back pain that was temporarily relieved with percutaneous injections to the joint space and lower lumber facets. A 65 year-old man underwent a left sacroliac arthrodesis for continued lumbosacral pain. The successful surgery with allograft had no intraoperative complications. The patient remained in the hospital post-operatively for four days with no complications. Four to six weeks post-operative, the patient began to have swelling and pain at the ipsilateral foot. The pain progressed with evidence of allodynia, hyperesthesia, and dystrophic changes in the foot. EMG and a nerve conduction study showed severe denervation that involved not only the muscles below the knee but the quadriceps as well, and also had ongoing irritability of a number of muscles, including those innervated by the femoral, sciatic, and gluteal nerves in the left leg. A diagnosis of complex regional pain syndrome Type 2 (causalgia) was made with the aid of a bone scan. A series of two diagnostic percutaneous chemical sympathectomies were undertaken, and the pain was significantly relieved. This suggested complex regional pain syndrome Type 2 with sympathetically maintained pain. The patient underwent aggressive physical therapy during his rehabilitation and subsequent resolution of the pain syndrome occurred. CONCLUSION:Complex regional pain syndrome Type 2 with sympathetically maintained pain is a condition that can result in serious disability and can be associated with spinal procedures and sacroiliac arthrodesis. Early intervention is recommended to provide long-term resolution of the condition.
journal_name
Pain Physicianjournal_title
Pain physicianauthors
Fish DEsubject
Has Abstractpub_date
2005-07-01 00:00:00pages
319-22issue
3eissn
1533-3159issn
2150-1149journal_volume
8pub_type
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