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Complex Regional Pain Syndrome following Spine Surgery: Clinical and Prognostic Implications

Wolter T.a · Knöller S.M.a, b · Rommel O.c
aInterdisciplinary Pain Center and bDepartment of Orthopaedic and Trauma Surgery, University Hospital Freiburg, Freiburg, and cRommel Klinik, Bad Wildbad, Germany Eur Neurol 2012;68:52–58 (DOI:10.1159/000337907)


Background: Complex regional pain syndrome (CRPS) has been reported following spinal surgery, but its frequency after spinal surgery is unknown. The aim of this study was to determine the frequency of spinal surgery preceding CRPS and to examine these patients regarding the course of the disease and prognostic factors. Methods: We examined 35 CRPS patients regarding the symptoms and signs of CRPS, the type of CRPS (I or II), the origin and grade of the disease, the type of surgeries prior to CRPS onset, the course of the disease, and the therapies following diagnosis of CRPS. Results: In 6 patients, CRPS began during the postoperative course (lumbar spine surgery, n = 5; cervical spine surgery, n = 1). Four of these patients suffered from CRPS II. The course of the disease in the 6 patients was not different from that of patients with CRPS of other origins. First symptoms of CRPS could be observed 1–14 days after surgery. Conclusions: CRPS is a rare complication after spinal surgery, but spinal surgery precedes the onset of CRPS of the lower limb in almost one-third of the cases. The first typical symptoms of CRPS emerge within 2 weeks after spinal surgery.


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