In this issue of the Scandinavian Journal of Pain, Kehua Zhou and co-workers present a case report on two patients treated for several years with intrathecal (IT) morphine due to chronic pain after multiple failed spinal operations . Despite this treatment, the patients had insufficient pain relief and compromised function for activities of daily living. This was emphasized by the use of additional opioids (per oral, transdermal) and willingness to undergo further back surgery during the ongoing IT morphine treatment. Additionally, the patients experienced severe side effects, including respiratory complications that caused visits at hospital emergency departments. One of the patients was also transferred to a nursing home after developing dementia-like symptoms. The two patients were finally included in a pain programme based on education, physiotherapy and tapering of opioids via conversion to methadone. After discontinuation of opioids both interestingly described better pain-control and improved function, and the patient showing symptoms of dementia improved and could be discharged home.1Post-surgical chronic back and leg pain (CBLP)The term post-surgical CBLP, formerly known as failed back surgery syndrome, describes a condition with persistent or recurring low back pain, with or without sciatica following one or more spine surgeries . The condition is
Scandinavian Journal of Pain – de Gruyter
Published: Oct 1, 2017
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