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Author Spotlight: Regenerative Peripheral Nerve Interface (RPNI) Surgery in Postamputation Pain Management

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Phantom radiculopathy: a rare postoperative phenomenon.

Maheswaran Archunan¹, Sriram Srinivasan

¹Trauma & Orthopaedics, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, UK archunan28@hotmail.com.

BMJ Case Reports

|May 15, 2020

Summary

Phantom radiculopathy, a rare complication after limb amputation, can be effectively treated with epidural corticosteroid injections, offering relief for persistent nerve pain long after surgery.

Keywords:

drug therapy related to surgery musculoskeletal and joint disorders orthopaedic and trauma surgery orthopaedics pain (neurology)

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Area of Science:

Neurology
Pain Medicine
Surgical Complications

Background:

Limb amputations are performed for various reasons including trauma, vascular disorders, infection, oncology, and congenital abnormalities.
Postoperative complications are common, with phantom limb pain being a well-documented issue.
Phantom radiculopathy is a less common but significant complication that is often overlooked due to limited literature.

Observation:

A patient developed phantom radiculopathy decades after a left above-knee amputation due to a road traffic accident.
The patient experienced persistent radicular pain symptoms mimicking nerve root irritation in the absent limb.
This delayed onset and rare presentation highlight the diagnostic challenges associated with phantom radiculopathy.

Findings:

The underlying pathophysiology of phantom radiculopathy remains poorly understood due to infrequent case descriptions.
Diagnostic workup for phantom radiculopathy requires careful consideration of patient history and symptom presentation.
This case underscores the potential for delayed-onset neuropathic pain syndromes following amputation.

Implications:

Prompt diagnosis and appropriate management are crucial for improving patient outcomes and quality of life.
Epidural corticosteroid injections represent a viable and effective treatment option for phantom radiculopathy.
Further research into the pathophysiology and treatment modalities for phantom radiculopathy is warranted to improve clinical care.