Successful spinal cord stimulation for chronic pancreatitis and post-laminectomy pain

2021 ◽  
Author(s):  
Cody J Cox ◽  
Michael M Wilkinson ◽  
Michael A Erdek
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Chronic Pancreatitis ◽  
Spinal Cord Stimulation ◽  
Visceral Pain ◽  
Epigastric Pain ◽  
The United States ◽  
Leg Pain ◽  
Pain Symptoms

Approximately one in five adults in the United States experiences chronic pain. Over the last 50 years, spinal cord stimulation has become increasingly recognized as a minimally invasive, efficacious treatment modality for the management of chronic pain. The authors report a case study of a 46-year-old female in the first documented spinal cord stimulation simultaneously targeting intractable neuropathic and visceral pain caused by post-laminectomy syndrome and chronic pancreatitis, respectively. This case study demonstrates near-total relief of the patient's neuropathic low back/leg pain and visceral epigastric pain, showing evidence of potential clinical usefulness for spinal cord stimulation as a treatment option in patients who present with a combination of visceral and somatic pain symptoms.

Spinal Cord Stimulation for Visceral Pain Related to Chronic Pancreatitis: Report of 2 Cases

2014 ◽  
Vol 81 (3-4) ◽  
pp. 651.e17-651.e19 ◽  
Author(s):  
Francesco Vergani ◽  
Alexandros Boukas ◽  
Nitin Mukerji ◽  
Nishma Nanavati ◽  
Claire Nicholson ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Chronic Pancreatitis ◽  
Spinal Cord Stimulation ◽  
Visceral Pain

scholarly journals Wireless High-Frequency Spinal Cord Stimulation (10 kHz) Compared with Multiwaveform Low-Frequency Spinal Cord Stimulation in the Management of Chronic Pain in Failed Back Surgery Syndrome Subjects: Preliminary Results of a Multicenter, Prospective Randomized Controlled Study

Pain Medicine ◽  
2019 ◽  
Vol 20 (10) ◽  
pp. 1971-1979 ◽  
Author(s):  
Robert Bolash ◽  
Michael Creamer ◽  
Richard Rauck ◽  
Payam Vahedifar ◽  
Aaron Calodney ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Spinal Cord Stimulation ◽  
High Frequency ◽  
Low Frequency ◽  
Failed Back Surgery Syndrome ◽  
Leg Pain ◽  
Trial Period ◽  
Failed Back Surgery ◽  
Back Surgery

Abstract Background This study aimed to evaluate the wireless Freedom Spinal Cord Stimulator (WSCS) System for the treatment of chronic back and/or leg pain associated with failed back surgery syndrome (FBSS) refractory to standard medical treatment utilizing 10-kHz stimulation (high-frequency [HF]) in comparison with 10–1,500-Hz stimulation (low-frequency [LF]) waveforms. Methods Ninety-nine subjects were randomized in a 1:1 ratio to receive either HF or LF stimulation waveforms utilizing the same Freedom WSCS System. All subjects were implanted with two 8-electrode arrays in the exact same anatomical positions within the dorsal epidural spinal column, with the top electrode positioned at the T8 and T9 vertebrae levels, respectively, and the wireless receiver placed under the skin in a subcutaneous pocket. Results Seventy-two (HF: N = 38; LF: N = 34) subjects had completed the six-month follow-up after an initial 30-day trial period at the time of this report. For both the HF and LF arms, mean visual analog scale (VAS) scores for back and leg pain decreased significantly: 77% and 76%, respectively, for the HF arm and 64% and 64%, respectively, for the LF arm. In addition, most subjects experienced significant improvements in VAS, Oswestry Disability Index, European Quality of Life 5 Dimension questionnaire, Patient Global Impression of Change, and sleep duration. Conclusions These preliminary results demonstrate that WSCS devices can reduce FBSS chronic pain substantially with both LF and HF stimulation waveforms over a seven-month period (30-day trial period and six-month post-trial evaluation).

scholarly journals Spinal Cord Stimulation for Intractable Visceral Pain due to Chronic Pancreatitis

2009 ◽  
Vol 46 (2) ◽  
pp. 165 ◽  
Author(s):  
Jin Kyung Kim ◽  
Seok Ho Hong ◽  
Myung-Hwan Kim ◽  
Jung-Kyo Lee
Keyword(s):  
Spinal Cord ◽  
Chronic Pancreatitis ◽  
Spinal Cord Stimulation ◽  
Visceral Pain

scholarly journals Squamous Cell Carcinoma Occurring Within Incision of Recently Implanted Spinal Cord Stimulator

2007 ◽  
Vol 6;10 (6;11) ◽  
pp. 771-774
Author(s):  
Joseph Atallah
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Postoperative Period ◽  
Spinal Cord Stimulation ◽  
Leg Pain ◽  
Wound Complications ◽  
Spinal Cord Stimulator

Spinal Cord Stimulation (SCS) is a treatment option for chronic pain patients. Spinal cord stimulation has been employed in the treatment of chronic pain for more than 30 years. The most common indication for SCS is the failed back syndrome with leg pain. Its indications have expanded beyond back and lower extremities pain to include axial low back pain, CRPS, mesenteric ischemia, peripheral neuropathy, limb ischemia, and refractory angina pectoris. The SCS has become a more versatile form of analgesia. The number of wound complications will surely rise in conjunction with the increasing number of devices being implanted. We describe a case of a well-differentiated squamous cell carcinoma occurring within the incision site of a recently implanted spinal cord stimulator early in the postoperative period. The patient developed a rapidly growing mass within the leads incision. The mass was confirmed to be squamous cell carcinoma by biopsy. The mass was excised under local anesthesia with appropriate margins. It was determined that the carcinoma did not extend below the dermis, and that there was no involvement of the underlying fascia. The device was tested for proper functioning, and the leads were thus left in place. While the development of skin malignancies in surgical wounds has been described in the literature, to our knowledge there have been no reports of a cutaneous neoplasm developing early in the postoperative period after spinal cord stimulator implantation. Key words: Spinal cord stimulator, CRPS type 1, squamous cell carcinoma

scholarly journals Real-World Outcomes Using a Spinal Cord Stimulation Device Capable of Combination Therapy for Chronic Pain: A European, Multicenter Experience

2021 ◽  
Vol 10 (18) ◽  
pp. 4085
Author(s):  
Jan Kallewaard ◽  
Jose Paz-Solis ◽  
Pasquale De Negri ◽  
Maria Canós-Verdecho ◽  
Hayat Belaid ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Chronic Pain ◽  
Combination Therapy ◽  
Spinal Cord Stimulation ◽  
Case Series ◽  
Leg Pain ◽  
Patient Specific ◽  
Effective Pain Relief

Given the differing mechanisms thought to underlie therapeutic sub- and supra-perception-based neurostimulative modalities, Spinal Cord Stimulation (SCS) systems designed for combined delivery of these approaches may help improve analgesic outcomes and quality of life, and reduce treatment failures. This multicenter, observational case-series evaluated 188 patients with chronic back and/or leg pain implanted with an SCS device capable of sequential or simultaneous delivery of sub-perception and supra-perception stimulation programming (i.e., combination therapy) at 16 sites in Europe. Following implantation, patients were provided with an array of advanced supra-perception programs (e.g., paresthesia-based SCS using multiple independent current sources), and a custom set of sub-perception programs optimized with specific waveforms and/or field shapes. A mean overall pain score of 7.9 ± 1.7 (Standard Deviation (SD)) was reported pre-trial (Baseline). Overall pain was reduced by 4.4 ± 2.8 points (NRS) at 3-months (n = 117) and at 12 months post-implant (n = 90), respectively (p < 0.0001). Substantial quality-of-life (EQ-5D-5L) improvement as assessed at last follow-up was also observed (n = 60). These results suggest that an implanted SCS device capable of combination therapy, while also enabled with patient-specific waveform optimization and stimulation field targeting capabilities, can enable highly effective pain relief and improve quality of life in patients suffering with chronic pain.

Spinal Cord Stimulation for Visceral Pain: Present Approaches and Future Strategies

Pain Medicine ◽  
2020 ◽  
Vol 21 (10) ◽  
pp. 2298-2309
Author(s):  
Royce W Woodroffe ◽  
Amy C Pearson ◽  
Amy M Pearlman ◽  
Matthew A Howard ◽  
Haring J W Nauta ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Pelvic Pain ◽  
Spinal Cord Stimulation ◽  
Chronic Pelvic Pain ◽  
Potential Role ◽  
Visceral Pain ◽  
The United States ◽  
Off Label ◽  
Pain Pathways ◽  
Implantation Techniques

Abstract Introduction The introduction of successful neuromodulation strategies for managing chronic visceral pain lag behind what is now treatment of choice in refractory chronic back and extremity pain for many providers in the United States and Europe. Changes in public policy and monetary support to identify nonopioid treatments for chronic pain have sparked interest in alternative options. In this review, we discuss the scope of spinal cord stimulation (SCS) for visceral pain, its limitations, and the potential role for new intradural devices of the type that we are developing in our laboratories, which may be able to overcome existing challenges. Methods A review of the available literature relevant to this topic was performed, with particular focus on the pertinent neuroanatomy and uses of spinal cord stimulation systems in the treatment of malignant and nonmalignant gastrointestinal, genitourinary, and chronic pelvic pain. Results To date, there have been multiple off-label reports testing SCS for refractory gastrointestinal and genitourinary conditions. Though some findings have been favorable for these organs and systems, there is insufficient evidence to make this practice routine. The unique configuration and layout of the pelvic pain pathways may not be ideally treated using traditional SCS implantation techniques, and intradural stimulation may be a viable alternative. Conclusions Despite the prevalence of visceral pain, the application of neuromodulation therapies, a standard approach for other painful conditions, has received far too little attention, despite promising outcomes from uncontrolled trials. Detailed descriptions of visceral pain pathways may offer several clues that could be used to implement devices tailored to this unique anatomy.

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