J Neurol Surg A Cent Eur Neurosurg 2013; 74(S 01): e92-e95
DOI: 10.1055/s-0032-1328952
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Radicular Pain from Lumbar Canal Stenosis in Addition to Pre-Existing Phantom Limb Pain

S. O. Tomasi
1   Department of Neurosurgery, Hirslanden Klinik St. Anna, Luzern, Switzerland
,
I. Ghani
1   Department of Neurosurgery, Hirslanden Klinik St. Anna, Luzern, Switzerland
,
D. Waldvogel
2   Department of Neurology, Hirslanden Klinik St. Anna, Luzern, Switzerland
,
O. Hausmann
1   Department of Neurosurgery, Hirslanden Klinik St. Anna, Luzern, Switzerland
› Author Affiliations
Further Information

Publication History

14 December 2011

12 May 2012

Publication Date:
20 February 2013 (online)

Abstract

Phantom limb (PL) is a term used to designate the sensation of the presence of an extremity following amputation, and it may be seen immediately after injury or years later in the part of the body that is deafferented or amputated. Phantom limb pain (PLP) is the term used to describe painful sensations referred to the absent limb. We present a case of a 71-year-old male with spinal claudication from discoligamentous lumbar canal stenosis L3–L4 and L4–L5 with L5 radicular pain in the left PL 13 years after the amputation. The patient had a disappearance of his radicular pain in the left PL following microsurgical lumbar decompression of L3–L4 and L4–L5. This is one of the rare cases reported in the literature in which a radicular pain in the PL disappeared following surgical decompression of the spinal canal.

 
  • References

  • 1 Finger S, Hustwit MP. Five early accounts of phantom limb in context: Paré, Descartes, Lemos, Bell, and Mitchell. Neurosurgery 2003; 52: 675-686 , discussion 685–686
  • 2 Thompson HM. Pain after amputation: is prevention better than cure?. Br J Anaesth 1998; 80: 415-416
  • 3 Wade NJ, Finger S. William Porterfield (ca. 1696-1771) and his phantom limb: an overlooked first self-report by a man of medicine. Neurosurgery 2003; 52: 1196-1198 , discussion 1198–1199
  • 4 Bailey AA, Moersch FP. Phantom limb. 1941. CMAJ 1992; 146: 1959-1965
  • 5 Bailey AA, Moersch FP. Phantom Limb. Can Med Assoc J 1941; 45: 37-42
  • 6 DeGregoris G, Diwan S. Phantom radiculitis effectively treated by fluoroscopically guided transforaminal epidural steroid injections. Pain Physician 2010; 13: 505-508
  • 7 Smuck M, Christensen S, Lee SS, Sagher O. An unusual cause of S1 radicular pain presenting as early phantom pain in a transfemoral amputee: a case report. Arch Phys Med Rehabil 2008; 89: 146-149
  • 8 Gruber H, Glodny B, Kopf H , et al. Practical experience with sonographically guided phenol instillation of stump neuroma: predictors of effects, success, and outcome. AJR Am J Roentgenol 2008; 190: 1263-1269
  • 9 Sherman RA, Sherman CJ, Gall NG. A survey of current phantom limb pain treatment in the United States. Pain 1980; 8: 85-99
  • 10 Sherman RA. Published treatments of phantom limb pain. Am J Phys Med 1980; 59: 232-244
  • 11 Kooijman CM, Dijkstra PU, Geertzen JH, Elzinga A, van der Schans CP. Phantom pain and phantom sensations in upper limb amputees: an epidemiological study. Pain 2000; 87: 33-41
  • 12 Haig AJ. Clinical experience with paraspinal mapping. II: A simplified technique that eliminates three-fourths of needle insertions. Arch Phys Med Rehabil 1997; 78: 1185-1190
  • 13 Sasso RC, Macadaeg K, Nordmann D, Smith M. Selective nerve root injections can predict surgical outcome for lumbar and cervical radiculopathy: comparison to magnetic resonance imaging. J Spinal Disord Tech 2005; 18: 471-478
  • 14 Anderberg L, Annertz M, Rydholm U, Brandt L, Säveland H. Selective diagnostic nerve root block for the evaluation of radicular pain in the multilevel degenerated cervical spine. Eur Spine J 2006; 15: 794-801
  • 15 Finneson BE. Nonsurgical treatment of low back pain. J Neurosurg Nurs 1977; 9: 54-57
  • 16 Lipton DE, Nagendran T. A rare cause of stump pain—herniated lumbar disc. A case report. Ala Med 1989; 58: 39-40
  • 17 Aydin MD, Cesur M, Aydin N, Alici HA. Disappearance of phantom limb pain during cauda equina compression by spinal meningioma and gradual reactivation after decompression. Anesth Analg 2005; 101: 1123-1126
  • 18 Chang VT, Tunkel RS, Pattillo BA, Lachmann EA. Increased phantom limb pain as an initial symptom of spinal-neoplasia. J Pain Symptom Manage 1997; 13: 362-364
  • 19 Ricard A, Girard PF. [Role of possible lumbo-sacral dislocation secondary to amputation of the lower extremity in genesis of certain causalgic pains of the stump]. Lyon Chir 1952; 47: 242-243