EFFECTIVE BUT NEAR DISASTROUS SUBARACHNOID NEUROLYSIS FOR MECHANICAL ROOT PAIN IN A PARAPLEGIC CANCER-PATIENT

Case Report: A 43-year-old white man with advanced renal cell carcinom a and consequent paraplegia complained of the new onset of lancinating pain involving the right upper chest wall. This pain, which was super imposed on well-controlled chronic back pain and was intermittent and related to activity, failed to respond to conventional pharmacologic m anagement. Methods and Results: A cisternal myelogram suggested an abs ence of gross rostral extension of spinal metastases, and subarachnoid neurolysis was per formed with hyperbaric phenol. Unexpected contrala teral brachial weakness developed towards the conclusion of the proced ure, but resolved spontaneously. The target pain had not recurred at f ollow-up 8 months later.