Management of Progressive Pain in a Patient With Intramedullary Chordoma of the Spine
作者:
G. Cerda-Olmedo,
J. De Andrés,
S. Moliner,
期刊:
The Clinical Journal of Pain
(OVID Available online 2002)
卷期:
Volume 18,
issue 2
页码: 128-131
ISSN:0749-8047
年代: 2002
出版商: OVID
关键词: Intraventricular approach;Chordoma;Spinal tumors
数据来源: OVID
摘要:
ObjectivesThe case here presented adequately reflects the difficulties involved in the treatment of pain in patients where the neuropathic component of pain predominates, and shows the different therapeutic steps that may be taken—from surgery and radiotherapy, to the administration of different drugs via the spinal route, to, finally, the presently little-used option of a direct intraventricular access.ConclusionsSpinal tumors are infrequent, but pose great difficulties for the management and control of the pain they cause. The utility of the spinal route as an early approach for the provision of adequate analgesia seems clear. However, it also appears to lose efficacy with time, and dose incrementing and/or the addition of drugs that enhance the analgesic action of morphine are not always effective. In such selected cases, the intraventricular route may constitute a useful alternative, allowing improved symptoms control with lower morphine doses, and the use of the system previously implanted for intrathecal spinal infusion.
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