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Published on: January 10, 2019
Cervical selective nerve root injection alleviates chronic refractory pain after brachial plexus avulsion: a case
Yoji Chikama1, Aiko Maeda2, Ryudo Tanaka1
1Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital, Fukuoka, 812-8582, Japan.
Background:
Intractable chronic pain, as well as motor, sensory, and autonomic neuropathy, significantly reduces the quality of life of brachial plexus avulsion (BPA) patients. We report the successful application of cervical selective nerve root injection (CSNRI) in a patient with BPA.
Case Presentation:
A 40-year-old man had been diagnosed with complete left BPA due to a motorcycle accident and underwent intercostal nerve transplantation at the age of 18 years and had been experiencing pain ever since. His pain increased after fracture of the left humerus, and he was referred to our pain management clinic. As his exacerbated pain was suspected to be due to peripheral nerve hypersensitivity, we performed repetitive ultrasound-guided CSNRI (3 mL of 1% mepivacaine of each) targeted C5 and 6 intervertebral foramina, and his symptoms gradually improved.
Conclusions:
Repetitive CSNRI may help diagnose and treat BPA-associated peripheral neuropathic pain, even in patients diagnosed with BPA.
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