EVALUATION OF CENTRAL SPINAL-CORD INJURY PAIN WITH DIAGNOSTIC SPINAL-ANESTHESIA

THE prevalence of chronic pain associated with spinal cord injury (SCI) varies considerably (5-94%).1 Donovan et al. describe five categories of chronic SCI pain: musculoskeletal, segmental, central, visceral, and psychogenic.2 In approximately 30% of SCI patients, pain is disabling, producing additional social handicaps.3 Recently, attention has turned to identifying mechanisms of nociception and effective treatment modalities for neuropathic SCI pain.4 Spinal anesthesia has been used effectively to demonstrate the mechanism and origin of nociception in various pain conditions.5 Furthermore, in SCI patients, it may elucidate the site of the ''neural pain generator'' with respect to the actual neurologic level of injury. However, in patients with cervical SCI, the use of diagnostic spinal anesthesia has not been well defined. The following report describes the response to diagnostic spinal anesthesia in a patient with chronic central pain associated with cervical SCI.