J Korean Pain Soc.  1997 May;10(1):86-88.

Pain Control by Spinal Cord Stimulation in the Reflex Sympathetic Dystrophy

• Lee SC
• Kim JH
• Hwang JW
• Han MA
• Kim SD
• Kim KM
• Lee BG

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 radio- frequency 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 O5) but the patient still could not walk due to remaining pain which was further aggravated by walking. After SCS, pain relief improved (VAS 5 O3) and patient could walk without assistance.

Keyword

Technique; Radioftequency thermocoagulation; Spinal cord stimulation; Sympathetic block- ade; Pain; Reflex sympathetic dystrophy

MeSH Terms

Anesthetics, Local
Ankle Injuries
Electrocoagulation
Humans
Leg
Neuralgia
Reflex Sympathetic Dystrophy*
Reflex*
Spinal Cord Stimulation*
Spinal Cord*
Sympathectomy
Walking
Anesthetics, Local