Indented intrathecal drug delivery system with loss of reservoir volume.
Indented intrathecal drug delivery system with loss of reservoir volume.
复制标题
锯齿状鞘内给药系统会造成储库容量损失。
DOI：
10.1136/rapm-2019-100516
复制
发表时间：
2019
影响因子：
5.1
通讯作者：
Schultz,DavidM
中科院分区：
文献类型：
--
作者：
Goel,Vasudha;Patwardhan,AmolM;Ibrahim,Mohab;Shankar,Hariharan;Schultz,DavidM
ObjectivesWe报告两名接受择期翻修手术的患者，发现鞘内给药系统（IDDS）的储液器容量减少，且底部护罩缩进。病例报告病例1：一名59岁男性，使用IDDS药物治疗慢性颈部和上背部疼痛，结果发现常规再灌注时储液器容量从40 cc不可逆减少至28 cc。尽管疼痛控制稳定，但储药器容量从40 cc降至22 cc，随后在患者疼痛控制不足时降至17 cc。在置换手术期间，发现IDDS的后护罩塌陷。患者接受高压氧治疗下肢慢性不愈合伤口。病例2：一名68岁女性因继发于腰椎手术失败综合征的慢性腰痛植入IDDS。在治疗的第七年，发现储药器容量从20 cc减少到15 cc。有人报告说有人摔倒了。在电池寿命结束时的常规水库交换显示，水库的底部屏蔽indented.ConclusionsInability重新填充药物，以充分的能力应该是一个迹象，调查设备变形。应获得有关暴露于高压氧治疗或局部创伤的信息。
ObjectivesWe report two patients who underwent elective revision surgery were found to have reduced reservoir volumes and indented bottom shield of intrathecal drug delivery system (IDDS).Case reportsCase #1: A 59-year-old man stable on IDDS medications for chronic neck and upper back pain was found to have an irreversible reduction in reservoir volume from 40 to 28 cc on routine refill appointment. Despite having stable pain control, the reservoir volume decreased from 40 to 22 cc and subsequently to 17 cc when the patient had inadequate pain control. During replacement surgery, the posterior shield of the IDDS was found to be collapsed. The patient had exposure to hyperbaric oxygen treatments for chronic non-healing wounds of the lower extremities. Case #2: A 68-year-old woman had an IDDS implanted for chronic low back pain secondary to failed back surgery syndrome. The reservoir volume was found to be reduced to 15 cc of medication from 20 cc during the seventh year of therapy. There was a report of a fall. Routine reservoir exchange at the end of battery life revealed that the bottom shield of the reservoir was indented.ConclusionsInability to refill the medication to full capacity should be an indication to investigate device deformation. Information about exposure to hyperbaric therapy or local trauma should be obtained.