Skip to main content
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology 1/2015

01.07.2015 | Original Article

Prevalence of neuropathic pain after radical sacral chordoma resection: an observational cohort study with 10-year follow-up

verfasst von: Rapin Phimolsarnti, Saranatra Waikakul

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Sonderheft 1/2015

Einloggen, um Zugang zu erhalten

Abstract

This study was carried out to discover the prevalence, characteristics and severity of neuropathic pain after wide resection of chordoma of the sacrum by the use of posterior approach. Patients who had chordoma of their sacrums and underwent wide resection via posterior approach, during 1990–2002, were followed up as a prospective cohort. Pain assessment was carried out in terms of onset, characteristics, intensity (numerical rating scale), response to pain medication and associated symptoms. The correlation between patients’ biographic data, preoperative neuropathic pain, type and levels of surgery and pain were analyzed. There were 21 patients; 14 male and 7 female patients. Their ages ranged between 29 and 75 years. Subtotal sacrectomy was carried out in 9 patients and total sacrectomy was carried out in 12 patients. All patients survived the operation. Neuropathic pain was found in 11 patients (52.4 %). Male patients and presentation of preoperative neuropathic pain were significantly related to postoperative neuropathic pain. The other factors were not related to the postoperative pain. Recurrent of severe pain with different characteristics after the operation might indicate tumor recurrent. Early detection of the pain and proper treatment could minimize pain intensity and improved pain management satisfaction.
Literatur
1.
2.
Zurück zum Zitat Zileli M, Hoscoskun C, Brastianos P, Sabah D (2003) Surgical treatment of primary sacral tumors: complications associated with sacrectomy. Neurosurg Focus 15:E9PubMed Zileli M, Hoscoskun C, Brastianos P, Sabah D (2003) Surgical treatment of primary sacral tumors: complications associated with sacrectomy. Neurosurg Focus 15:E9PubMed
4.
Zurück zum Zitat Varga PP, Szövérfi Z, Lazary A (2014) Surgical treatment of primary malignant tumors of the sacrum. Neurol Res 36:577–587PubMedCrossRef Varga PP, Szövérfi Z, Lazary A (2014) Surgical treatment of primary malignant tumors of the sacrum. Neurol Res 36:577–587PubMedCrossRef
5.
Zurück zum Zitat Fourney DR, Rhines LD, Hentschel SJ, Skibber JM, Wolinsky JP, Weber KL, Suki D, Gallia GL, Garonzik I, Gokaslan ZL (2005) En bloc resection of primary sacral tumors: classification of surgical approaches and outcome. J Neurosurg Spine 3:111–122PubMedCrossRef Fourney DR, Rhines LD, Hentschel SJ, Skibber JM, Wolinsky JP, Weber KL, Suki D, Gallia GL, Garonzik I, Gokaslan ZL (2005) En bloc resection of primary sacral tumors: classification of surgical approaches and outcome. J Neurosurg Spine 3:111–122PubMedCrossRef
7.
Zurück zum Zitat Guo W, Tang X, Zang J, Ji T (2013) One-stage total en bloc sacrectomy: a novel technique and report of 9 cases. Spine (Phila Pa 1976) 38:E626–E631CrossRef Guo W, Tang X, Zang J, Ji T (2013) One-stage total en bloc sacrectomy: a novel technique and report of 9 cases. Spine (Phila Pa 1976) 38:E626–E631CrossRef
8.
Zurück zum Zitat Clarke MJ, Dasenbrock H, Bydon A, Sciubba DM, McGirt MJ, Hsieh PC, Yassari R, Gokaslan ZL, Wolinsky JP (2012) Posterior-only approach for en bloc sacrectomy: clinical outcomes in 36 consecutive patients. Neurosurgery 71:357–364PubMedCrossRef Clarke MJ, Dasenbrock H, Bydon A, Sciubba DM, McGirt MJ, Hsieh PC, Yassari R, Gokaslan ZL, Wolinsky JP (2012) Posterior-only approach for en bloc sacrectomy: clinical outcomes in 36 consecutive patients. Neurosurgery 71:357–364PubMedCrossRef
9.
Zurück zum Zitat Angelini A, Ruggieri P (2013) A new surgical technique (modified Osaka technique) of sacral resection by posterior-only approach: description and preliminary results. Spine (Phila Pa 1976) 38:E185–E192CrossRef Angelini A, Ruggieri P (2013) A new surgical technique (modified Osaka technique) of sacral resection by posterior-only approach: description and preliminary results. Spine (Phila Pa 1976) 38:E185–E192CrossRef
10.
Zurück zum Zitat Solomon MJ, Tan KK, Bromilow RG, Al-mozany N, Lee PJ (2014) Sacrectomy via the abdominal approach during pelvic exenteration. Dis Colon Rectum 57:272–277PubMedCrossRef Solomon MJ, Tan KK, Bromilow RG, Al-mozany N, Lee PJ (2014) Sacrectomy via the abdominal approach during pelvic exenteration. Dis Colon Rectum 57:272–277PubMedCrossRef
11.
Zurück zum Zitat Saigal R, Lu DC, Deng DY, Chou D (2014) Conversion of high sacral to midsacral amputation via S-2 nerve preservation during partial S-2 sacrectomy for chordoma. J Neurosurg Spine 20:421–429PubMedCrossRef Saigal R, Lu DC, Deng DY, Chou D (2014) Conversion of high sacral to midsacral amputation via S-2 nerve preservation during partial S-2 sacrectomy for chordoma. J Neurosurg Spine 20:421–429PubMedCrossRef
12.
Zurück zum Zitat Li D, Guo W, Tang X, Yang R, Tang S, Qu H, Yang Y, Sun X, Du Z (2013) Preservation of the contralateral sacral nerves during hemisacrectomy for sacral malignancies. Eur Spine J (Epub ahead of print) Li D, Guo W, Tang X, Yang R, Tang S, Qu H, Yang Y, Sun X, Du Z (2013) Preservation of the contralateral sacral nerves during hemisacrectomy for sacral malignancies. Eur Spine J (Epub ahead of print)
13.
Zurück zum Zitat Jahangiri FR, Al Eissa S, Jahangiri AF, Al-Habib A (2013) Intraoperative neurophysiological monitoring during sacrectomy procedures. Neurodiagn J 53:312–322PubMed Jahangiri FR, Al Eissa S, Jahangiri AF, Al-Habib A (2013) Intraoperative neurophysiological monitoring during sacrectomy procedures. Neurodiagn J 53:312–322PubMed
14.
Zurück zum Zitat Devor M (2013) Neuropathic pain: pathophysiologic response of nerves to injury. In: McMahon SB, Koltzenburg M, Tracey I, Turk D (eds) Wall and Melzack textbook of pain, 6th edn. Elsevier, Philadelphia, pp 861–888 Devor M (2013) Neuropathic pain: pathophysiologic response of nerves to injury. In: McMahon SB, Koltzenburg M, Tracey I, Turk D (eds) Wall and Melzack textbook of pain, 6th edn. Elsevier, Philadelphia, pp 861–888
15.
Zurück zum Zitat Jensen MP, Chodroff MJ, Dworkin RH (2007) The impact of neuropathic pain on health-related quality of life: review and implications. Neurology 68:1178–1182PubMedCrossRef Jensen MP, Chodroff MJ, Dworkin RH (2007) The impact of neuropathic pain on health-related quality of life: review and implications. Neurology 68:1178–1182PubMedCrossRef
16.
Zurück zum Zitat O’Connor AB (2009) Neuropathic pain: a review of the quality of life impact, costs, and cost-effectiveness of therapy. Pharmacoeconomics 27:95–112PubMedCrossRef O’Connor AB (2009) Neuropathic pain: a review of the quality of life impact, costs, and cost-effectiveness of therapy. Pharmacoeconomics 27:95–112PubMedCrossRef
17.
Zurück zum Zitat Hansson PT (2008) Neuropathic pain: definition, diagnosis criteria, clinical phenomenology, and differential diagnosis issues. In: Castro-Lopes J, Raja S, Schmelz M (eds) Pain 2008: an updated review, refresher course syllabus. IASP Press, Seattle, pp 271–276 Hansson PT (2008) Neuropathic pain: definition, diagnosis criteria, clinical phenomenology, and differential diagnosis issues. In: Castro-Lopes J, Raja S, Schmelz M (eds) Pain 2008: an updated review, refresher course syllabus. IASP Press, Seattle, pp 271–276
18.
Zurück zum Zitat Sherman RA (2003) Postamputation pain. In: Jensen TS, Wilson PR, Rice ASC (eds) Clinical pain management: chronic pain, 1st edn. Arnold, London, pp 427–436 Sherman RA (2003) Postamputation pain. In: Jensen TS, Wilson PR, Rice ASC (eds) Clinical pain management: chronic pain, 1st edn. Arnold, London, pp 427–436
19.
Zurück zum Zitat Chavez NF, Zweizig SL, Stewart EA (2003) Neuropathic uterine pain after hysterectomy. A case report. J Reprod Med 48:466–468PubMed Chavez NF, Zweizig SL, Stewart EA (2003) Neuropathic uterine pain after hysterectomy. A case report. J Reprod Med 48:466–468PubMed
20.
Zurück zum Zitat Rothemund Y, Grosser SM, Liebeskind U, Schlag PM, Flor H (2004) Phantom phenomena in mastectomized patients and their relation to chronic and acute pre-mastectomy pain. Pain 107:140–146PubMedCrossRef Rothemund Y, Grosser SM, Liebeskind U, Schlag PM, Flor H (2004) Phantom phenomena in mastectomized patients and their relation to chronic and acute pre-mastectomy pain. Pain 107:140–146PubMedCrossRef
21.
Zurück zum Zitat Nikolajsen L, Jensen TS (2006) Phantom pain. In: McMahon SB, Koltzenburg M (eds) Wall and Melzack’s textbook of pain, 5th edn. Elsevier, Churchill Livingstone, China, pp 961–972CrossRef Nikolajsen L, Jensen TS (2006) Phantom pain. In: McMahon SB, Koltzenburg M (eds) Wall and Melzack’s textbook of pain, 5th edn. Elsevier, Churchill Livingstone, China, pp 961–972CrossRef
22.
Zurück zum Zitat Marbach JJ, Raphael KG (2000) Phantom tooth pain: a new look at an old dilemma. Pain Med 1:68–77PubMedCrossRef Marbach JJ, Raphael KG (2000) Phantom tooth pain: a new look at an old dilemma. Pain Med 1:68–77PubMedCrossRef
23.
Zurück zum Zitat Hsu C, Sliwa JA (2004) Phantom breast pain as a source of functional loss. Am J Phys Med Rehabil 83(8):659–662PubMedCrossRef Hsu C, Sliwa JA (2004) Phantom breast pain as a source of functional loss. Am J Phys Med Rehabil 83(8):659–662PubMedCrossRef
24.
Zurück zum Zitat Guo Y, Yadav R (2002) Improving function after total sacrectomy by using a lumbar-sacral corset. Am J Phys Med Rehabil 81:72–76PubMedCrossRef Guo Y, Yadav R (2002) Improving function after total sacrectomy by using a lumbar-sacral corset. Am J Phys Med Rehabil 81:72–76PubMedCrossRef
Metadaten
Titel
Prevalence of neuropathic pain after radical sacral chordoma resection: an observational cohort study with 10-year follow-up
verfasst von
Rapin Phimolsarnti
Saranatra Waikakul
Publikationsdatum
01.07.2015
Verlag
Springer Paris
Erschienen in
European Journal of Orthopaedic Surgery & Traumatology / Ausgabe Sonderheft 1/2015
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-014-1533-x

Weitere Artikel der Sonderheft 1/2015

European Journal of Orthopaedic Surgery & Traumatology 1/2015 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

TEP mit Roboterhilfe führt nicht zu größerer Zufriedenheit

15.05.2024 Knie-TEP Nachrichten

Der Einsatz von Operationsrobotern für den Einbau von Totalendoprothesen des Kniegelenks hat die Präzision der Eingriffe erhöht. Für die postoperative Zufriedenheit der Patienten scheint das aber unerheblich zu sein, wie eine Studie zeigt.

Lever-Sign-Test hilft beim Verdacht auf Kreuzbandriss

15.05.2024 Vordere Kreuzbandruptur Nachrichten

Mit dem Hebelzeichen-Test lässt sich offenbar recht zuverlässig feststellen, ob ein vorderes Kreuzband gerissen ist. In einer Metaanalyse war die Vorhersagekraft vor allem bei positivem Testergebnis hoch.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.