AAPS, American Association of Plastic Surgeons
AAPS, American Association of Plastic Surgeons
Twitter YouTube LinkedIn
2008 Annual Meeting Abstracts

Back to 87th Annual Meeting
Back to Program Outline


Successful Surgical Approach to Complex Regional Pain Syndrome
A Lee Dellon, MD, PhD, Gedge D. Rosson, MD.
Johns Hopkins University, Baltimore, MD, USA.

PURPOSE:
The patient with complex regional pain syndrome (CRPS) can achieve relief by decreasing painful inputs to the dorsal spinal column through decompression of a peripheral nerve, resection of a painful neuroma, denervation of a painful joint, or a combination of these approaches. Corollary: Decreasing sympathetic output is not essential to treat CRPS.
METHODS:
A retrospective chart review was carried out on 100 consecutive patients with the diagnosis of CRPS from 01-01-2000 through 12-31-05. Each patient had been in pain management prior to referral. Of the 100 patients, 70 were selected for surgery based upon the Hx, PEx, computer-assisted neurosensory testing, and, where indicated, nerve blocks, that demonstrated that a peripheral nerve problem might be responsible for their continuing pain. Thirty patients were rejected due to either failure of the nerve block to relieve their pain, or suspected secondary gain issues. Of the 70 CRPS patients included, 40 had upper and 30 had lower extremity peripheral nerve surgery. While all had general anesthesia, in select patients, indwelling brachial plexus or epidural catheter blockade also was used.
RESULTS:
At a mean post-operative time interval of 15 months, and based upon decreased pain medication usage, recovery of function, repeat Hx and PEx, outcome in the upper extremity patients was: excellent in 55%, good in 35% and a failure in 10%. Outcome in the lower extremity patients was similar: excellent in 66% , good in 30% and a failure in 4%.
CONCLUSION:
Complex Regional Pain Syndrome can be treated successfully by Identification of peripheral sites of painful spinal input, decompression of those sites related to compression, and resection of those sites related to a neuroma. CRPS does not necessitate long-term anti-sympathetic drugs.


Back to 87th Annual Meeting
Back to Program Outline

Quick Links
About
Membership
Annual Meeting
Awards
Publications
Pledge
 
Twitter YouTube LinkedIn