J Korean Neurosurg Soc.  2016 Sep;59(5):529-532. 10.3340/jkns.2016.59.5.529.

Treatment for Acute Stage Complex Regional Pain Syndrome Type II with Polydeoxyribonucleotide Injection

• Jang KS
• Kim HS

• KMID: 2351725
• DOI: http://doi.org/10.3340/jkns.2016.59.5.529

Abstract

Complex regional pain syndrome (CRPS) type II is a syndrome that develops after nerve injury. Symptoms may be severe, and vary depending on the degree of sympathetic nerve involvement. As yet, there is no satisfactory treatment. We report the case of a female patient who had an L5 left transverse process fracture and an S2 body fracture, who developed symptoms of CRPS type II in her left lower leg that were aggravated during ambulation in spite of absolute bed rest for one month after the trauma. Several treatments, including bed rest, medication, and numerous nerve blocks were attempted, but the pain persisted. We finally tried injection of polydeoxyribonucleotide (PDRN) solution at the left L5 transverse process fracture site because we knew of the anti-inflammatory effect of PDRN. One day after this treatment, her symptoms had almost disappeared and three days later, she was discharged. We will also further discuss the possibility of using PDRN solution for the treatment of CRPS.

Keyword

Complex regional pain syndrome; Polydeoxyribonucleotides

MeSH Terms

Bed Rest
Causalgia*
Female
Humans
Leg
Nerve Block
Polydeoxyribonucleotides
Walking
Polydeoxyribonucleotides

Figure

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  Fig. 1 A 32-year-old female patient sustained left L5 transverse process fracture and S2 body fracture in a fall. Neither linear fracture has a surgical indication.

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  Fig. 2 The patient exhibits skin flushing on the left lower leg. This sign is a hallmark of disturbed sympathetic nerve activity.

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  Fig. 3 Two needles are inserted at the fracture site. After puncture of the intertransverse ligament, polydeoxyribonucleotide solution is injected along the course of lumbosacral plexus.

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  Fig. 4 The flushing of the skin of the left lower leg is markedly reduced one day after polydeoxyribonucleotide injection, the color difference between the two lower legs negligible.

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