Two years follow-up of continuous erector spinae plane block in a patient with upper extremity complex regional pain syndrome type I
Bibliographic record
Abstract
BACKGROUND: Recalcitrant complex regional pain syndrome (CRPS) type 1 is a devastating condition. CASE PRESENTATION: We report a case of a patient in their twenties with left hand and forearm CRPS type I, transiently responsive to spinal cord stimulation, thoracic sympathectomy, and multimodal analgesia. The investigators initiated a trial of a single-shot erector spinae plane block at the T2 level, resulting in a clinically significant improvement in pain, function, vasomotor and sudomotor symptoms transiently for a 36-hour interval. As a result, a permanent e-port catheter implantation under combined ultrasound and fluoroscopic guidance was trialed. Two-year follow-up of the continuous erector spinae plane block (CESPB) indicated an 80% reduction in pain scores from baseline, and a 50% reduction in opiate consumption, with a clinically significant reduction in swelling, color changes, allodynia, and temperature asymmetry. CONCLUSION: Recalcitrant CRPS type 1 is a challenging life-altering condition that results in a cyclical triad of chronic pain, disability, and impaired psychosocial health. The profound and prolonged analgesic response to CESPB, highlights the clinical utility of this technique, and warrants more clinical investigation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".