37 year old lady with Complex Regional Pain Syndrome (CRPS) treated succesfully with Lumbar Sympathectomy.
Presenting features of CRPS
This lady was seen in the Pain Clinic. She had been previously treated with a number of medications including Pregabalin, Fentanyl, Vitamin C, Tramadol, Oxycodone, Gabapentin and Amitriptyline.
Although she had become reasonably well controlled with the medication, she was still getting a lot of pain from the complex regional pain syndrome in her right ankle. This started following an ankle fracture, which lead to the requirement for insertion of ankle plates and screws.
Minimally invasive pain management procedures for CRPS
The lady had had a lumbar sympathectomy, which had given her some short term benefit. She was then given a lumbar sympathectomy at 2 levels; L2 and L3, using pulse radiofrequency at 120 seconds at 42˚c, as well as 20 mls of 0.5% Bupivacaine and 80 mg of Depo-Medrone.
Follow-up after Lumbar Sympathectomy for CRPS
At 8 weeks post procedure she was found to have significant pain relief and the decision was made to start to reduce the doses of medication she was taking. She will be reviewed in a further 3 months.