Complex regional pain syndrome associated with cervical disc protrusion and foraminotomy.

STUDY DESIGN Case report. OBJECTIVE To report a previously undescribed association between complex regional pain syndrome (CRPS) and surgery for cervical disc protrusion. SUMMARY OF BACKGROUND DATA Although CRPS has been associated with disc protrusion and lumbar spine surgery, there is no record in the literature of a similar association with cervical disc protrusion. METHODS Description of a clinical case. RESULTS A patient with radicular pain due to cervical disc protrusions underwent posterior foraminotomy, which did not relieve his pain. Within 3-4 weeks, he developed features of CRPS. Review at 16, 22, and 34 months revealed some, but limited, improvement. CONCLUSIONS This case provides circumstantial evidence of a hitherto undescribed association between CRPS and cervical disc protrusion. The mechanism is elusive, but may involve damage to small nerves in or near the intervertebral foramina.