A 13-year-old girl was diagnosed with CRPS of the right lower limb secondary to an ankle fracture.
She was referred to the Pain Unit by the Pediatric Traumatology Service.
Pharmacological treatment was initiated without adequate analgesic result so it was decided (previous information and obtaining consent from parents) the implantation, in the operating room and under general anesthesia, of a lumbar epidural catheter connected to a continuous external pump for administration.
Complete pain relief was obtained as well as the rest of the symptoms, but this disappeared after withdrawal of bupivacaine infusion, reappearing both pain and other accompanying symptoms.
With prior information and paterno consent, an octopolar electrode was implanted in the posterior spinal cord at T12-T9 level under general anesthesia and connected to an external pulse generator.
The patient was programmed to suffer from paraesthesia with a good level of pain relief.
This allowed the patient to start rehabilitation of the affected limb.
Two weeks later, the patient continued relief without using the external pulse generator.
The external generator was deconnected and the rehabilitation treatment was continued, citing the patient four weeks later.
The persistence of absence of pain and improvement of accompanying symptoms was decided (according to parents) to explant the medullary electrode.
The patient continues with complete remission of symptoms.
