{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T08:17:16Z","timestamp":1787732236740,"version":"build-2784847793"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,5,28]],"date-time":"2017-05-28T00:00:00Z","timestamp":1495929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Limb amputation is sometimes being performed in long\u2010standing complex regional pain syndrome (<jats:styled-content style=\"fixed-case\">CRPS<\/jats:styled-content>), although little evidence is available guiding management decisions, including how <jats:styled-content style=\"fixed-case\">CRPS<\/jats:styled-content> recurrence should be managed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This report details the management of a young soldier with <jats:styled-content style=\"fixed-case\">CRPS<\/jats:styled-content> recurrence 2 years after midtibial amputation for <jats:styled-content style=\"fixed-case\">CRPS<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Conventional spinal cord stimulation did not achieve paraesthetic coverage, or pain relief in the stump, whereas L4 dorsal root ganglion stimulation achieved both coverage and initially modest pain relief, and over time, substantial pain relief.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Current evidence does not support the use of amputation to improve either pain or function in <jats:styled-content style=\"fixed-case\">CRPS<\/jats:styled-content>. Before a decision is made, in exceptional cases, about referral for amputation, dorsal root ganglion stimulation should be considered as a potentially effective treatment, even where conventional spinal cord stimulator treatment has failed to achieve reliable paraesthetic cover. Furthermore, this treatment may provide pain relief in those patients with <jats:styled-content style=\"fixed-case\">CRPS<\/jats:styled-content> recurrence in the stump after amputation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/papr.12582","type":"journal-article","created":{"date-parts":[[2017,4,18]],"date-time":"2017-04-18T15:39:04Z","timestamp":1492529944000},"page":"104-108","source":"Crossref","is-referenced-by-count":24,"title":["Dorsal Root Ganglion Stimulation for Complex Regional Pain Syndrome (CRPS) Recurrence after Amputation for CRPS, and Failure of Conventional Spinal Cord Stimulation"],"prefix":"10.1111","volume":"18","author":[{"given":"Andreas","family":"Goebel","sequence":"first","affiliation":[{"name":"Walton Centre NHS Foundation Trust Liverpool U.K."},{"name":"Pain Research Institute University of Liverpool Liverpool U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Lewis","sequence":"additional","affiliation":[{"name":"Defense Medical Rehabilitation Centre Headley Court Epson Surrey U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhodri","family":"Phillip","sequence":"additional","affiliation":[{"name":"Defense Medical Rehabilitation Centre Headley Court Epson Surrey U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manohar","family":"Sharma","sequence":"additional","affiliation":[{"name":"Walton Centre NHS Foundation Trust Liverpool U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,5,28]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e3181a11623"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200008313430904"},{"key":"e_1_2_6_4_1","unstructured":"National Institute for Health and Care Excellence.Spinal cord stimulation for chronic pain of neuropathic or ischemic origin.2008.https:\/\/www.nice.org.uk\/Guidance\/TA159(accessed May 18 2017)"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.L.00532"},{"key":"e_1_2_6_6_1","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1302\/0301-620X.77B2.7706345","article-title":"Amputation for reflex sympathetic dystrophy","volume":"77","author":"Dielissen PW","year":"1995","journal-title":"J Bone Joint Surg Br"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ner.12228"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/papr.12170"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2010.04.030"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000028686.74056.E3"},{"key":"e_1_2_6_11_1","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1093\/bja\/aev183","article-title":"Racemic ketamine 4.5\u2010day infusion treatment of long\u2010standing complex regional pain syndrome\u2014a prospective service evaluation in five patients","volume":"115","author":"Goebel A","year":"2015","journal-title":"Br J Anaesth"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2009.06.023"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2009.08.015"},{"key":"e_1_2_6_14_1","volume-title":"Complex Regional Pain Syndrome in Adults. 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