• Pain Pract · Sep 2012

    Review Case Reports

    The delayed appearance of neurological signs in intrathecal granuloma warrants imaging surveillance: a case series and review of the literature.

    • Richard L Rauck and Amanda Zimmerman.
    • West Forsyth Pain Management, Clemmons, North Carolina, USA. dmczim@gmail.com
    • Pain Pract. 2012 Sep 1;12(7):561-9.

    AbstractIntrathecal pump therapy (ITP) has become a mainstay of treatment for the chronic, refractory nonmalignant pain patient. Increasingly, ITP therapy is being instituted for the failed back pain population. Inflammatory mass or granuloma is a complication that is considered "rare" or "uncommon." In this patient population, the symptoms of granuloma can often mimic the symptoms for which the patient is being treated. The case series reported here illustrates 4 cases of inflammatory mass. One patient presented with paralysis before she was diagnosed, and the remainder of the patients were asymptomatic at the time of diagnosis. The cases presented illustrate the need for broader education of inflammatory mass among nonpain specialists. Etiology, diagnosis and treatment guidelines of inflammatory mass are reviewed. The literature reviewed highlights the number of patients who present with paralysis as well as the need for regular screening of ITP patients.© 2012 The Authors. Pain Practice © 2012 World Institute of Pain.

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