Phantom Limb Pain in Young Cancer-related Amputees

Abstract

Objectives This study in children and young adults having cancer-related amputation aimed to examine the incidence of phantom limb pain in the first year after amputation and also the proportion of patients who had pre-amputation pain. Methods A retrospective review of medical records was undertaken. The proportion of patients with phantom limb pain was reported. Fisher’s exact test was used to examine the association between phantom limb pain and the presence of pre-amputation pain and between phantom limb pain and age (≤18 years vs. >18 years). Results 26 amputations were performed on 25 patients. During the year following amputation, 76% of patients had experienced phantom limb pain at some time. After 1 year, though, only 10% still had phantom limb pain. Pre-amputation pain was present in 64% of patients. Although both of our patients with PLP at 1 year were young adults (≥18 years) and both had pre-amputation pain, we found no statistically significant associations between age or the presence of pre-amputation pain with phantom limb pain. Discussion Phantom limb pain following cancer related amputation in children and young adults appears to be common but generally short lived in most patients.

Mirror Therapy for Phantom Limb Pain at a Pediatric Oncology Institution

“…Our findings are consistent with those of the study by Krane et al which found that over a 10-year period, 90% of pediatric cancer–related amputations resulted in PLP 8 , and they are slightly higher than the findings of the study by Burgoyne et al, which reported that 76% of patients had PLP, and only 10% experienced PLP that persisted at 1 year post-amputation. 7 …”

“…7 The study evaluated factors to predict PLP, and although all patients who experienced PLP 1 year after amputation were older than 18 years, had pre-amputation pain, and had a proximal limb amputation, none of these factors were statically significant, possibly due to the small sample size. 7 Patients who undergo pediatric cancer–related amputations have a higher incidence of PLP (90%) than the pediatric amputation population as a whole (83%). 8 …”

Phantom Limb Pain in Pediatric Oncology

“…For congenitally related amputations, the prevalence of PLP has been noted to be lower, between 3.7 and 20% of children, even occurring in children with congenital absence of a limb ( 4 , 10 ). In the pediatric oncology population, the prevalence of PLP is also wide ranging between 48 and 90% ( 5 , 7 , 11 , 12 ). The onset of pediatric PLP typically occurs shortly after amputation, most often within the first week after amputation ( 5 , 7 ).…”

“…Phantom limb pain may also be related to pre-amputation pain in pediatric populations, although results of this research have been mixed. Pre-amputation pain has been noted to be present in 35–90% of pediatric amputation patients ( 4 , 5 , 11 ). A recent study (2012), however, did not find a significant difference between the experience of pre-amputation pain and the development of PLP post-amputation ( 11 ).…”

“…Pre-amputation pain has been noted to be present in 35–90% of pediatric amputation patients ( 4 , 5 , 11 ). A recent study (2012), however, did not find a significant difference between the experience of pre-amputation pain and the development of PLP post-amputation ( 11 ). Similarly, a 1995 study did not find a significant correlation between the experience of pre-amputation pain and post-amputation PLP, but did note the majority of patients experiencing PLP also experienced preoperative pain ( 5 ).…”