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Spinal cord compression in a patient with a pain pump for failed back syndrome: a chalk-like precipitate mimicking a spinal cord neoplasm: case report.

AbstractOBJECTIVE AND IMPORTANCE:
The use of intrathecal morphine has been effective with few complications for chronic intractable pain of both benign and malignant origins. A rare but serious problem that exists is the formation of an inflammatory mass at the catheter tip of the pain pump.
CLINICAL PRESENTATION:
We report the case of a 67-year-old female patient with failed back syndrome who presented with sensory complaints and back pain.
INTERVENTION:
Magnetic resonance imaging revealed impingement on the thoracic cord by a mass. The mass was originally thought to be a spinal cord tumor; however, operation and chemical analysis of the mass showed that it was a bupivacaine precipitate at the tip of the catheter of the pain pump.
CONCLUSION:
This is the first such case, to our knowledge, of a bupivacaine precipitate mimicking a spinal cord tumor.
AuthorsRishi K Wadhwa, Mark R Shaya, Anil Nanda
JournalNeurosurgery (Neurosurgery) Vol. 58 Issue 2 Pg. E387; discussion E387 (Feb 2006) ISSN: 1524-4040 [Electronic] United States
PMID16462469 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Calcium Carbonate
  • Bupivacaine
Topics
  • Aged
  • Back Pain (diagnostic imaging, drug therapy)
  • Bupivacaine (administration & dosage)
  • Calcium Carbonate
  • Diagnosis, Differential
  • Female
  • Humans
  • Infusion Pumps, Implantable (adverse effects)
  • Radiography
  • Spinal Cord Compression (diagnostic imaging, drug therapy)
  • Spinal Cord Neoplasms (diagnostic imaging, drug therapy)
  • Syndrome
  • Thoracic Vertebrae (diagnostic imaging, drug effects)

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