You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

Traumatic Syrinx After Implantation of an Intrathecal Catheter

Harney, Donal C.A.R.C.S.I., F.C.A.R.C.S.I.a; Victor, Raymond C.A.R.C.S.I., F.C.A.R.C.S.I.a

Regional Anesthesia & Pain Medicine:
Case report
Abstract

Objective: This case report describes the diagnosis and subsequent management of a very unusual complication of intrathecal pump insertion, namely that of traumatic syrinx secondary to the presence of an intrathecal catheter within the substance of the spinal canal.

Case Report: A woman with a 10‐year history of chronic pain after a fall was scheduled to have an intrathecal pump inserted to deliver morphine as a continuous infusion. The intrathecal space was entered at L1/L2. Under fluoroscopic imaging, the catheter was threaded to the T6 level. The catheter was then secured and tunneled subcutaneously and implanted in the anterior abdominal wall. After implantation, the patient complained of difficulty in moving her left leg with loss of spinothalamic sensation on her left side from T6 to L5. Magnetic resonance imaging (MRI) showed a traumatic syrinx secondary to the presence of an intrathecal catheter within the substance of the canal. The catheter was removed, and serial MRI revealed the syrinx had not increased in size. The patient underwent reinsertion of an intrathecal catheter for control of her pain. Her postoperative course thereafter was uneventful.

Conclusion: Insertion of an intrathecal catheter may be associated with spinal cord trauma in patients receiving general anesthesia. Serial neurologic examinations and MRI are helpful in guiding treatment.

Author Information

aDepartment of Anaesthesia Intensive Care and Pain Medicine, Saint Vincent's University Hospital, Dublin, Ireland

Accepted for publication August 18, 2004

Reprint requests: Donal Harney, C.A.R.C.S.I., F.C.A.R.C.S.I., Department of Anaesthesia Intensive Care and Pain Medicine, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland. E‐mail: dharney@rcsi.ie

©2004 American Society of Regional Anesthesia and Pain Medicine