Management of Intrathecal Catheter-Tip Inflammatory Masses: A Consensus Statement
dc.contributor.author | Hassenbusch, Samuel | en_US |
dc.contributor.author | Burchiel, Kim | en_US |
dc.contributor.author | Coffey, Robert J. | en_US |
dc.contributor.author | Cousins, Michael J. | en_US |
dc.contributor.author | Deer, Tim | en_US |
dc.contributor.author | Hahn, Marc B. | en_US |
dc.contributor.author | Pen, Stuart Du | en_US |
dc.contributor.author | Follett, Kenneth A. | en_US |
dc.contributor.author | Krames, Elliot | en_US |
dc.contributor.author | Rogers, James N. | en_US |
dc.contributor.author | Sagher, Oren | en_US |
dc.contributor.author | Staats, Peter S. | en_US |
dc.contributor.author | Wallace, Mark | en_US |
dc.contributor.author | Willis, Kenneth Dean | en_US |
dc.date.accessioned | 2010-06-01T21:59:25Z | |
dc.date.available | 2010-06-01T21:59:25Z | |
dc.date.issued | 2002-12 | en_US |
dc.identifier.citation | Hassenbusch, Samuel; Burchiel, Kim; Coffey, Robert J.; Cousins, Michael J.; Deer, Tim; Hahn, Marc B.; Pen, Stuart Du; Follett, Kenneth A.; Krames, Elliot; Rogers, James N.; Sagher, Oren; Staats, Peter S.; Wallace, Mark; Willis, Kenneth Dean (2002). " Management of Intrathecal Catheter-Tip Inflammatory Masses: A Consensus Statement." Pain Medicine 3(4): 313-323. <http://hdl.handle.net/2027.42/75020> | en_US |
dc.identifier.issn | 1526-2375 | en_US |
dc.identifier.issn | 1526-4637 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/75020 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=15099236&dopt=citation | en_US |
dc.description.abstract | In a companion article, we synthesized current clinical and preclinical data to formulate hypotheses about the etiology of drug administration catheter-tip inflammatory masses. In this article, we communicate our recommendations for the detection, treatment, mitigation, and prevention of such masses. Methods. We reviewed published and unpublished case reports and our own experiences to find methods to diagnose and treat catheter-tip inflammatory masses in a manner that minimized adverse neurological sequelae. We also formulated hypotheses about theoretical ways to mitigate, and possibly, prevent the formation of such masses. Results. Human cases have occurred only in patients with chronic pain who received intrathecal opioid drugs, alone or mixed with other drugs, or in patients who received agents that were not labeled for long-term intrathecal use. Most patients had noncancer pain owing to their large representation among the population with implanted pumps. Such patients also had a longer life expectancy and exposure to intrathecal drugs, and they received higher daily doses than patients with cancer pain. Clues to diagnosis included the loss of analgesic drug effects accompanied by new, gradually progressive neurological symptoms and signs. When a mass was diagnosed before it filled the spinal canal or before it caused severe neurological symptoms, open surgery to remove the mass often was not required. Anecdotal reports and the authors' experiences suggest that cessation of drug administration through the affected catheter was followed by shrinkage or disappearance of the mass over a period of 2-5 months. Conclusions. Attentive follow-up and maintenance of an index of suspicion should permit timely diagnosis, minimally invasive treatment, and avoidance of neurological injury from catheter-tip inflammatory masses. Whenever it is feasible, positioning the catheter in the lumbar thecal sac and/or keeping the daily intrathecal opioid dose as low as possible for as long possible may mitigate the seriousness, and perhaps, reduce the incidence of such inflammatory masses. | en_US |
dc.format.extent | 545442 bytes | |
dc.format.extent | 3109 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.publisher | Blackwell Science Inc | en_US |
dc.rights | 2002 American Academy of Pain Medicine | en_US |
dc.subject.other | Complications | en_US |
dc.subject.other | Granuloma | en_US |
dc.subject.other | Inflammatory Mass | en_US |
dc.subject.other | Intraspinal Catheter | en_US |
dc.subject.other | Intrathecal Drugs | en_US |
dc.subject.other | Morphine | en_US |
dc.subject.other | Pain | en_US |
dc.title | Management of Intrathecal Catheter-Tip Inflammatory Masses: A Consensus Statement | en_US |
dc.type | Article | en_US |
dc.subject.hlbsecondlevel | Medicine (General) | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Department of Neurological Surgery, University of Michigan Medical Center, Ann Arbor, Michigan; | en_US |
dc.contributor.affiliationother | Department of Neurological Surgery, University of Texas M.D. Anderson Cancer Center, Houston, Texas; | en_US |
dc.contributor.affiliationother | Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon; | en_US |
dc.contributor.affiliationother | Medtronic, Inc., Minneapolis, Minnesota; | en_US |
dc.contributor.affiliationother | Department of Anaesthesia and Pain Management, University of Sydney, New South Wales, Australia; | en_US |
dc.contributor.affiliationother | The Center for Pain Relief, Charleston, West Virginia; | en_US |
dc.contributor.affiliationother | Fort Worth, Texas; | en_US |
dc.contributor.affiliationother | Swedish Hospital Pain Management, Seattle, Washington; | en_US |
dc.contributor.affiliationother | University of Iowa Hospitals and Clinics, Iowa City, Iowa; | en_US |
dc.contributor.affiliationother | Pacific Pain Treatment Center, San Francisco, California; | en_US |
dc.contributor.affiliationother | Department of Anesthesiology, University of Texas Health Sciences Center, San Antonio, Texas; | en_US |
dc.contributor.affiliationother | Department of Anesthesiology, Johns Hopkins Hospital, Baltimore, Maryland; | en_US |
dc.contributor.affiliationother | Department of Anesthesiology, University of California, San Diego, California; | en_US |
dc.contributor.affiliationother | Alabama Pain Center, Huntsville, Alabama | en_US |
dc.identifier.pmid | 15099236 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/75020/1/j.1526-4637.2002.02055.x.pdf | |
dc.identifier.doi | 10.1046/j.1526-4637.2002.02055.x | en_US |
dc.identifier.source | Pain Medicine | en_US |
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dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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