QUALITY OF LIFE AFTER AMPUTATION IN PATIENTS WITH ADVANCED COMPLEX REGIONAL PAIN SYNDROME-A SYSTEMATIC REVIEW

The treatment of CRPS is difficult, varied and there are no clear guidelines or pathways. This is more complex in advanced and resistant CRPS. Our aim was to conduct a systematic review on the results of amputation in advanced and resistant CRPS and the effect on quality of life. The literature was reviewed, inclusion criteria was implemented and 11 studies were selected. 68% patients who underwent Amputation had improvement in QOL. 28% patients had deterioration of symptoms. The improvement with Amputation was more apparent in recent, good quality studies (up to 81%). Post amputation complications included phantom limb pain (65%), stump pain (30%) and recurrence of CRPS (43%). Our conclusion was that in selected cases with advanced, unresponsive CRPS, amputation can be considered as an option to improve QOL. However, there are risks of further deterioration and complications. Results are better if the procedure is carried out in specialised centres after MDT assessment.