The impact of immunological parameters on the development of phantom pain after major amputation.

Abstract

To investigate the relationship between local and systemic inflammatory markers and phantom limb pain. In 39 consecutive patients undergoing major amputations nerve biopsies, serum and clinical data was collected. Patients were followed up for 12 months to report on the incidence and severity of phantom limb pain. After 12 months, 78% of the surviving patients had phantom pain, the symptom usually commencing within 14 days of operation. The severity of macrophage infiltration within the nerve biopsy was negatively correlated to the inception of phantom pain ( P = 0.026). While serum TNF-alpha concentration was positively correlated to mortality ( P = 0.021). The immune status existing before the amputation and the local immunological milieu influence the onset of phantom pain.