• Neurosurgery · Feb 2006

    Case Reports

    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.

    • Rishi K Wadhwa, Mark R Shaya, and Anil Nanda.
    • Department of Neurosurgery, Louisiana State University, Health Sciences Center, Shreveport 71130-3932, USA.
    • Neurosurgery. 2006 Feb 1;58(2):E387; discussion E387.

    Objective And ImportanceThe 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 PresentationWe report the case of a 67-year-old female patient with failed back syndrome who presented with sensory complaints and back pain.InterventionMagnetic 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.ConclusionThis is the first such case, to our knowledge, of a bupivacaine precipitate mimicking a spinal cord tumor.

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