Failure in long-term treatment of chronic pain in cervical spondylotic myelopathy.

Cervical spondylotic myelopathy is a disease of high variability and its progressive form leads to severe disability. This paper reports on a case of a 31-year-old woman with whiplash neck injury sustained at the age of 11, and subsequent neck pain and numbness of arms. Slow progression of symptoms led to tetraparesis, and C3C4 disc herniation along with cervical myelopathy were revealed at the age of 26. Previously, she started a treatment for hypothyroidism. She underwent anterior cervical discectomy and fusion. Two additional operative treatments were done during the next two years due to lack of clinical improvement. Because of chronic pain the number of medications and the number of symptoms have gradually increased. We emphasize the problem of long-term treatment for chronic non-malignant pain and therapeutic dilemma in situations of inadequate analgesia.