Intrathecal granuloma complicating chronic spinal infusion of morphine. Report of three cases.

@article{Blount1996IntrathecalGC,
  title={Intrathecal granuloma complicating chronic spinal infusion of morphine. Report of three cases.},
  author={Jeffrey P Blount and Kent B. Remley and Samuel K. Yue and Donald L. Erickson},
  journal={Journal of neurosurgery},
  year={1996},
  volume={84 2},
  pages={
          272-6
        }
}
Intrathecal morphine delivered by implanted pumps has been used in the treatment of pain caused by terminal cancer. Some authors supports its use in benign pain as well. The authors present three cases in which chronic infiltration of intraspinal narcotic medication was complicated by the formation of a granulomatous mass that became large enough to exert mass effect and induce neurological dysfunction. 
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A review of intrathecal morphine therapy related granulomas
Intrathecal Granuloma and Intramedullary Abscess Associated With an Intrathecal Morphine Pump
TLDR
This is the first reported case of an intramedullary abscess and intrathecal inflammatory mass associated with an intr Athecal drug delivery system and it is shown that cord compression resulting from the formation of an intratheCal inflammatory mass in patients using intrathe CAL drug delivery systems is documented.
Primary Hydromorphone‐Related Intrathecal Catheter Tip Granulomas: Is There a Role for Dose and Concentration?
TLDR
Studies suggest a strong correlation between the use of higher doses and concentrations of intrathecal opiates and ICTG formation and a relatively infrequent, but potentially devastating complication.
Intrathecal Morphine Therapy‐Related Granulomas: Faster to Grow than Thought
TLDR
A case where a catheter‐tip granuloma formed within 5 weeks of intrathecal morphine is presented, where the patient was carrying an intratheCal pump for 3 months when it was diagnosed.
Intrathecal Granuloma in Patients Receiving High‐dose Intrathecal Morphine Therapy: A Report of Two Cases
TLDR
The clinical, radiographic, and pathological reports of two cases of intrathecal inflammatory tissue masses are described and a review of the literature as to the clinical presentation, radiography evidence, pathological reports, evaluation/treatment strategies, and pathophysiological hypotheses will be presented.
Patients with a History of Spine Surgery or Spinal Injury may have a Higher Chance of Intrathecal Catheter Granuloma Formation
Intrathecal drug delivery is an effective method to treat intractable pain. However, intrathecal catheter tip granuloma (ICTG) is a devastating complication of intrathecal drug delivery systems. It…
Spinal cord compression secondary to intrathecal catheter–induced granuloma: a report of four cases
TLDR
The formation of granulomas caused by intrathecal catheter implantation is a rare but serious complication and imaging studies including magnetic resonance imaging with contrast and computed tomography with myelogram should be used to follow up a neurological examination consistent with spinal cord compression.
Granulomatous Conduit for Intrathecal Infusion of Morphine and Bupivacaine
TLDR
This case report reinforces the view that the infusate is the causal agent of this lesion, as the leakage site had been encapsulated by drug concretion and granuloma formation, thus providing a sealed conduit that reestablished drug flow between the pump and the catheter.
Spinal cord compression by catheter granulomas in high-dose intrathecal morphine therapy: case report.
TLDR
Intrathecal granulomas are likely to occur with increasing frequency as the use of chronic intrathecal morphine delivery increases in patients with nonmalignant pain.
Case scenario: self-extraction of intrathecal pump medication with a concomitant intrathecal granulomatous mass.
TLDR
Key points essential for the diagnosis and treatment of intrathecal granulomatous masses are highlighted and the vigilance required by physicians managing patients with intratheCal drug delivery systems are highlighted.
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References

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TLDR
A fibrous reaction that developed around the catheter tip progressed into a mass that caused a significant displacement of the spinal cord with the development of long tract symptoms and led to prompt surgical decompression resulting in improvement of the patient's condition.
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TLDR
A fibrous reaction that developed around the catheter tip progressed into a mass that caused a significant displacement of the spinal cord with the development of long tract symptoms and led to prompt surgical decompression resulting in improvement of the patient's condition.
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TLDR
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TLDR
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TLDR
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TLDR
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