What is inflammatory granuloma?

Question: What is inflammatory granuloma?

Answer: Inflammatory granuloma, a rare complication that may happen when you have a drug delivery pump implanted, is the development of an inflammatory mass right where the catheter is inserted. Inflammatory granuloma occurs more frequently when the drug delivery system is implanted in the intrathecal space (inside the layers of the spinal cord itself), as opposed to the epidural space (just outside the spinal cord). Approximately 1% of patients who are at risk for inflammatory granuloma due to drug deliver system implantation actually develop the condition.

Some of the early signs of inflammatory granuloma include loss of sensation and pain in the dermatome that corresponds to the place in the spinal cord the catheter was inserted. Later signs include paralysis and bowel and/or baldder dysfunction. If your doctor determines that you have inflammatory granuloma, she will stop the drug delivery immediately, and you may need surgery.

Prevention may be accomplished by changing the medications delivered by the pump, using more than one area for catheter insertion and/or not allowing dosages of morphine and hydromorphone to get too high.

_{Sources:
Patrick J. McIntyre, MD, JD; Timothy R. Deer, MDb; and Salim M. Hayek, MD, PhD. Complications of spinal infusion therapies Techniques in Regional Anesthesia and Pain Management Volume 11, Issue 3, July 2007, Complications of Interventional Pain Procedures
Stedman's Medical Dictionary. 28th ed. Lippincott Williams & Wilkins. Baltimore. 2006/}