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[Reflex sympathetic dystrophy secondary to lumbar disk herniation]
Rinsho Shinkeigaku = Clinical Neurology
|January 1, 1994
Summary
Reflex sympathetic dystrophy (RSD) secondary to lumbar disk herniation is rare. A lumbar sympathetic block effectively relieved symptoms in a patient with severe disability from L5 radiculopathy and RSD.
Area of Science:
- Neurology
- Pain Management
- Radiology
Background:
- Lumbar disk herniation can cause radiculopathy, potentially leading to complex regional pain syndromes.
- Reflex sympathetic dystrophy (RSD), now known as complex regional pain syndrome (CRPS), is a poorly understood condition characterized by autonomic dysfunction.
Observation:
- A 26-year-old woman presented with left foot discoloration, swelling, dysesthesia, allodynia, and claudication.
- Physical examination revealed left lower extremity weakness, atrophy, hypertrichosis, and cool skin.
- Radiography showed patchy osteoporosis, and an intravenous phentolamine test suggested RSD.
Findings:
- A repeat CT scan identified an extraforaminal L4/5 disk herniation compressing the L5 nerve root.
- The patient was diagnosed with RSD secondary to L5 radiculopathy.
- A left L2, 3 lumbar sympathetic block provided significant relief from allodynia and claudication.
Implications:
- Lumbar sympathetic blocks can be an effective treatment for RSD secondary to lumbar disk herniation, even in severe cases.
- This case highlights the importance of considering radiculopathy as a cause of secondary RSD.
- Further research into the mechanisms and optimal treatment of RSD secondary to spinal pathology is warranted.