Long-Term Reduction of Sacroiliac Joint Pain With Peripheral Nerve Stimulation

2017 ◽  
Vol 13 (5) ◽  
pp. 634-639 ◽  
Author(s):  
Marin Guentchev ◽  
Christian Preuss ◽  
Rainer Rink ◽  
Levente Peter ◽  
Martin H. M. Sailer ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Sacroiliac Joint ◽  
Peripheral Nerve Stimulation ◽  
Term Therapy ◽  
Treatment Results ◽  
Satisfaction Index ◽  
Average Pain

Abstract BACKGROUND: We recently demonstrated that 86% of the patients treated with peripheral nerve stimulation (PNS) for therapy-refractory sacroiliac joint (SIJ) pain were satisfied with the result after 1 year of treatment. OBJECTIVE: To investigate the long-term (up to 4 years) response rate of this novel treatment. METHODS: Sixteen consecutive patients with therapy-refractory SIJ pain were treated with PNS and followed for 4 years in 3 patients, 3 years in 6 patients, and 2 years in 1 patient. Quality of life, pain, and patient satisfaction were assessed using the Oswestry Disability Index 2.0, Visual Analog Scale (VAS), and International Patient Satisfaction Index. RESULTS: Patients reported a pain reduction from 8.8 to 1.6 (VAS) at 1 year (P < .001), and 13 of 14 patients (92.9%) rated the therapy as effective (International Patient Satisfaction Index score ≤ 2). At 2 years, average pain score was 1.9 (P < .001), and 9 of 10 patients (90.0%) considered the treatment a success. At 3 years, 8 of 9 patients (88.9%) were satisfied with the treatment results, reporting an average VAS of 2.0 (P < .005). At 4 years, 2 of 3 patients were satisfied with the treatment results. CONCLUSION: We have shown for the first time that PNS is a successful long-term therapy for SIJ pain.

Outcome measures and outcomes of peripheral nerve stimulation of the sacroiliac joint

2021 ◽  
pp. 147-160
Author(s):  
Hunter Hoopes ◽  
Mayank Gupta
Keyword(s):  
Peripheral Nerve ◽  
Outcome Measures ◽  
Nerve Stimulation ◽  
Sacroiliac Joint ◽  
Adverse Outcomes ◽  
Peripheral Nerve Stimulation ◽  
Advantages And Disadvantages ◽  
Pain Assessment Scales ◽  
Patient’S Perception ◽  
Stimulation Of

This chapter focuses on the most commonly used questionnaires and pain assessment scales that are used both clinically and in the research setting, and it compares and contrasts their validity and accuracy. Reliable outcome measures are essential to translate the complex perception of pain into measurable data. Several questionnaires and grading scales have been developed, each with their own inherent advantages and disadvantages. In addition to quantitative measures of pain, this chapter explores what other qualitative measures are useful to understand a patient’s perception of pain, their functional ability, and even potential adverse outcomes. Finally, this chapter demonstrates how some of these measures have already been used in the literature specifically in the context of peripheral nerve stimulation of the sacroiliac joint.

Preoperative considerations for peripheral nerve stimulation of the sacroiliac joint

2021 ◽  
pp. 129-134
Author(s):  
Ajay B. Antony
Keyword(s):  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Sacroiliac Joint ◽  
Infection Risk ◽  
Peripheral Nerve Stimulation ◽  
Anticoagulation Management ◽  
Perioperative Antibiotics ◽  
Planning Strategies ◽  
Preoperative Plan ◽  
Stimulation Of

This chapter reviews preoperative factors to be considered before performing peripheral nerve stimulation of the sacroiliac joint. When designing a preoperative plan, it is important to consider the type of anesthesia to be administered, anticoagulation management, infection risk, and other relevant medical comorbidities that may complicate the procedure. These factors vary depending on the patient, and in many cases coordination with other specialists is required. Optimization of patient comorbidities, appropriate management of anticoagulation, and planning strategies to minimize infection risk (including the use of perioperative antibiotics) are paramount to ensure the best possible outcomes for the patient undergoing this procedure.

Long-term results of peripheral nerve stimulation for reflex sympathetic dystrophy

1996 ◽  
Vol 84 (3) ◽  
pp. 415-423 ◽  
Author(s):  
Samuel J. Hassenbusch ◽  
Michael Stanton-Hicks ◽  
Derek Schoppa ◽  
James G. Walsh ◽  
Edward C. Covington
Keyword(s):  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Reflex Sympathetic Dystrophy ◽  
Peripheral Nerve Stimulation ◽  
Third Party ◽  
Long Term Results ◽  
Spontaneous Pain ◽  
Consecutive Series ◽  
Full Time

✓ This prospective, consecutive series describes peripheral nerve stimulation (PNS) for treatment of severe reflex sympathetic dystrophy (RSD) or complex regional pain syndrome, in patients with symptoms entirely or mainly in the distribution of one major peripheral nerve. Plate-type electrodes were placed surgically on affected nerves and tested for 2 to 4 days. Programmable generators were implanted if 50% or more pain reduction and objective improvement in physical changes were achieved. Patients were followed for 2 to 4 years and a disinterested third-party interviewer performed final patient evaluations. Of 32 patients tested, 30 (94%) underwent permanent PNS placement. Long-term good or fair relief was experienced in 19 (63%) of 30 patients. In successfully treated patients, allodynic and spontaneous pain was reduced on a scale of 10 from 8.3 ± 0.3 preimplantation to 3.5 ± 0.4 (mean ± standard error of the mean) at latest follow up (p < 0.001). Changes in vasomotor tone and patient activity levels were markedly improved but motor weakness and trophic changes showed less improvement. Six (20%) of the 30 patients undergoing PNS placement returned to part-time or full-time work after being unemployed prestimulator implantation. Initial involvement of more than one major peripheral nerve correlated with a poor or no relief rating (p < 0.01). Operative modifications that minimize technical complications are described. This study indicates that PNS can provide good relief for RSD that is limited to the distribution of one major nerve.

scholarly journals Peripheral Nerve Stimulation for the Treatment of Chronic Intractable Headaches: Long-term Efficacy and Safety Study

2015 ◽  
Vol 5;18 (5;9) ◽  
pp. 505-516
Author(s):  
Billy K. Huh
Keyword(s):  
Retrospective Study ◽  
Peripheral Nerve ◽  
Pain Intensity ◽  
Nerve Stimulation ◽  
Peripheral Nerve Stimulation ◽  
Key Words Migraine ◽  
Efficacy And Safety ◽  
Refractory Headache ◽  
Chronic Headaches

Background: Despite the various modalities available for treating headaches, typical therapy does not provide adequate pain relief for some patients. Objectives: This study explored the efficacy and safety of long-term peripheral nerve stimulation (PNS) for intractable chronic headaches. Study Design: Retrospective study of refractory headache patients at academic pain center. Methods: The medical records of all patients (N = 46) permanently implanted with PNS between January 2005 and January 2012 were reviewed retrospectively. Patient records and phone interviews were used to quantify the levels of pain intensity, headache days per month, and overall patient satisfaction with treatment. The correlation between headache duration and effectiveness of PNS was also assessed. Results: Pain intensity on the 11-point Numeric Rating Scale decreased from 7.60 ± 1.73 before implantation to 3.78 ± 2.41, 3.32 ± 2.67, 3.42 ± 2.74, and 2.04 ± 2.27 at one, 6, 12, and > 12 (19 – 98) months after implantation, respectively (P < .001). The mean number of headache days per month decreased by about 14 days from the base line. No correlation (r = -.33) was found between the number of years the patients had suffered from headaches and the efficacy of treatment. Limitations: Due to the limitation of a retrospective study, the data collected via chart reviews and phone interviews are susceptible to selection and information biases. Conclusions: PNS is an effective modality in the long-term management of intractable chronic headaches. Despite long histories of chronic headaches, the majority of patients had significant reductions in pain scores and the number of headache days per month. The outcomes were not dependent on the number of years the patients had suffered from headaches before PNS treatment. Key Words: Migraine headache, refractory headache, chronic daily headache, occipital neuralgia, cluster headache, hemicranias continua, refractory headache, occipital nerve stimulation, peripheral nerve stimulation

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