Abstrakt
We report a case of early formation of a catheter tip granuloma in a patient with multilevel degenerative spinal stenosis who developed a granuloma in spite of the fact that morphine dosage was at lower rate and administered for a short period of time only. Methods: A 58-year-old woman with a history of chronic low back pain due to the failed back surgery syndrome was treated effectively with 5mg/day morphine via an intrathecal drug delivery system (IDDS).
Eight months after IDDS replacement due to end-of- battery-life, the patient experienced new severe pain radiating diffusely to the left leg and accompanied by slight weakness. Results: MRI disclosed multilevel degenerative spondylogenic stenosis and an intradural extramedullar mass at the T11 level with spinal cord compression.
The patient underwent decompressive hemilaminectomy and removal of adherent fibrotic tissue attached to the spinal cord and to the tip of the intrathecal catheter. Conclusions: In this patient, a narrow spinal canal, which may have created unfavorable conditions for proper CSF circulation, may have facilitated morphine-associated granuloma formation despite a short-term low dose treatment.