PMID- 27037439 OWN - NLM STAT- MEDLINE DCOM- 20160830 LR - 20221207 IS - 2049-4408 (Electronic) IS - 2049-4394 (Linking) VI - 98-B IP - 4 DP - 2016 Apr TI - Amputation in patients with complex regional pain syndrome: a comparative study between amputees and non-amputees with intractable disease. PG - 548-54 LID - 10.1302/0301-620X.98B4.36422 [doi] AB - AIMS: Amputation in intractable cases of complex regional pain syndrome (CRPS) remains controversial. The likelihood of recurrent Complex Regional Pain Syndrome (CRPS), residual and phantom limb pain and persistent disability after amputation is poorly described in the literature. The aims of this study were to compare pain, function, depression and quality of life between patients with intractable CRPS who underwent amputation and those in whom amputation was considered but not performed. PATIENTS AND METHODS: There were 19 patients in each group, with comparable demographic details. The amputated group included 14 men and five women with a mean age of 31 years (sd 12) at the time of CRPS diagnosis. The non-amputated group consisted of 12 men and seven women and their mean age of 36.8 years (sd 8) at CRPS diagnosis. The mean time from CRPS diagnosis to (first) amputation was 5.2 years (sd 4.3) and the mean time from amputation to data collection was 6.6 years (sd 5.8). All participants completed the following questionnaires: Short-Form (SF) 36, Short Form McGill Pain questionnaire (SF-MPQ), Pain Disability Index (PDI), the Beck Depression Inventory (BDI) and a clinical demographic questionnaire. RESULTS: The amputation group showed consistently better results compared to the non-amputation group in the following parameters: median pain intensity (VAS): 80 (inter-quartile range (IQR) 13 to 92) vs 91 (IQR 85 to 100); p = 0.007; median SF-MPQ score 28 (IQR 9 to 35) vs 35 (IQR 31 to 38), p = 0.025; median PDI: 42 (IQR 11 to 64) vs 58 (IQR 50 to 62), p = 0.031; median BDI: 19 (IQR 5 to 28) vs 27 (IQR 21 to 32), p = 0.061 (borderline significant) and in six of the eight SF-36 domains. TAKE HOME MESSAGE: Amputation should be considered as a form of treatment for patients with intractable CRPS. CI - (c)2016 The British Editorial Society of Bone & Joint Surgery. FAU - Midbari, A AU - Midbari A AD - Institute of Pain Medicine, Pain Research Unit, Rambam Health Care Campus, P.O. Box 9602, Haifa 3109601, Israel. FAU - Suzan, E AU - Suzan E AD - Institute of Pain Medicine, Pain Research Unit, Rambam Health Care Campus, P.O. Box 9602, Haifa 3109601, Israel. FAU - Adler, T AU - Adler T AD - Institute of Pain Medicine, Rambam Health Care Campus, Haifa, Israel. FAU - Melamed, E AU - Melamed E AD - Rambam Health Care Campus, Department of Orthopedics Haifa, Israel. FAU - Norman, D AU - Norman D AD - Rambam Health Care Campus, Department of Orthopedics, Haifa, Israel. FAU - Vulfsons, S AU - Vulfsons S AD - Institute of Pain Medicine, Rambam Health Care Campus, Haifa, Israel. FAU - Eisenberg, E AU - Eisenberg E AD - Institute of Pain Medicine, Pain Research Unit, Rambam Health Care Campus, P.O. Box 9602, Haifa 3109601, Israel. LA - eng PT - Comparative Study PT - Journal Article PL - England TA - Bone Joint J JT - The bone & joint journal JID - 101599229 SB - IM MH - Adult MH - *Amputation, Surgical MH - *Amputees MH - Complex Regional Pain Syndromes/*etiology/rehabilitation MH - Female MH - Follow-Up Studies MH - Humans MH - Male MH - Pain Measurement MH - Quality of Life MH - Retrospective Studies MH - *Surveys and Questionnaires OTO - NOTNLM OT - Complex regional pain syndrome (CRPS); Reflex sympathetic dystrophy (RSD);amputation; depression; Intractable pain; Disability EDAT- 2016/04/03 06:00 MHDA- 2016/08/31 06:00 CRDT- 2016/04/03 06:00 PHST- 2015/04/28 00:00 [received] PHST- 2015/10/05 00:00 [accepted] PHST- 2016/04/03 06:00 [entrez] PHST- 2016/04/03 06:00 [pubmed] PHST- 2016/08/31 06:00 [medline] AID - 98-B/4/548 [pii] AID - 10.1302/0301-620X.98B4.36422 [doi] PST - ppublish SO - Bone Joint J. 2016 Apr;98-B(4):548-54. doi: 10.1302/0301-620X.98B4.36422.