Spinal cord and peripheral nerve stimulation should be used earlier in the treatment algorithm for neuropathic pain

2011 ◽  
Vol 1 (1) ◽  
pp. 7-10 ◽  
Author(s):  
Timothy R Deer
Keyword(s):  
Spinal Cord ◽  
Neuropathic Pain ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Treatment Algorithm ◽  
Peripheral Nerve Stimulation

scholarly journals Peripheral Nerve Stimulation of the Lateral Femoral Cutaneous and Superior Gluteal Nerves for Treating Proximal Neuropathy Hip Pain

2020 ◽  
pp. 221-224
Author(s):  
Niek Vanquathem
Keyword(s):  
Drug Delivery ◽  
Spinal Cord ◽  
Neuropathic Pain ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Spinal Cord Stimulation ◽  
Hip Pain ◽  
Peripheral Nerve Stimulation ◽  
Peripheral Neuropathic Pain ◽  
Intrathecal Drug Delivery

Background: Chronic postoperative hip pain is estimated to occur in 10% to 35% of patients undergoing total hip replacement. Proximal peripheral neuropathic pain of the lateral femoral cutaneous and superior gluteal nerves has proven to be a difficult disorder to treat. Opioids are often ineffective in the treatment of neuropathic pain. Interventional methods such as peripheral nerve stimulation are minimally invasive options capable of relieving neuropathic pain. Stimulators powered by an implantable pulse generator (IPG), however, may not be suitable for peripheral nerve stimulation because of difficulty finding an appropriate pocket site. The introduction of wireless peripheral nerve stimulation has improved the ability to offer this modality. Case Presentation: We present a case of proximal peripheral neuropathic pain of the lateral femoral cutaneous and superior gluteal nerves that failed all other treatment modalities including spinal cord stimulation and intrathecal drug delivery. Two quadripolar, tined, wireless electrode arrays were positioned over the lateral femoral cutaneous and superior gluteal nerves. A stimulation scheme with a pulse rate of 1.5 kHz and pulse width of 30 μs at 2.0 mA was tested and found effective. Conclusion: This patient had proximal neuropathic hip pain and failed a variety of chronic pain treatment options, including conventional IPG-based spinal cord stimulation and an intrathecal drug delivery system. She was successfully treated with a wireless peripheral nerve stimulation system. Key words: Hip pain, lateral femoral cutaneous nerve, peripheral nerve stimulator, peripheral neuropathy, superior gluteal nerve

scholarly journals Advancement in Neuromodulation Technology with the Innovation of Design-Specific Peripheral Nerve Stimulators: Sural Nerve Stimulation for Radiculopathy

Pain Medicine ◽  
2020 ◽  
Vol 21 (6) ◽  
pp. 1297-1300
Author(s):  
Brendan Langford ◽  
William D Mauck
Keyword(s):  
Spinal Cord ◽  
Neuropathic Pain ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Sural Nerve ◽  
Peripheral Nerve Stimulation ◽  
Epidural Steroid Injections ◽  
Dorsal Portion ◽  
The 1960S ◽  
Epidural Steroid

Abstract Background Peripheral nerve stimulation (PNS) is a form of neuromodulation that is used to treat chronic and refractory neuropathic pain. Peripheral nerve stimulation was first described in the early 1960s when Shelden implanted a PNS device for trigeminal neuralgia. Despite PNS being known since the 1960s, technology designed specifically for PNS was lacking. Within the past few years, design-specific PNS devices have become widely available, with favorable efficacy and safety profiles. Here we report a case of design-specific PNS that provided two years of pain relief in a patient with lower extremity neuropathic pain. Case Presentation A 53-year-old female with a history of congenital lumbar meningocele status post–L4-L5 laminectomy presented to the Mayo Clinic for treatment of foot pain that began three days after her laminectomy. She experienced a 6/10 burning, tingling sensation in the lateral dorsal portion of her right foot and posterolateral calf in addition to allodynia that prevented her from wearing shoes. She failed gabapentin, amitriptyline, cannabis, transforaminal epidural steroid injections, and two spinal cord stimulator trials. The patient ultimately underwent implantation of a right sural nerve stimulator, resulting in a 50% improvement in pain and functionality at two-year follow-up. Conclusions This report emphasizes the recent development of design-specific PNS devices and their successful use in this patient. Peripheral nerve stimulation technology and applications have diminished the role of spinal cord stimulation devices used for the periphery. Peripheral nerve stimulation should be considered for patients with isolated extremity pain, especially in those with spinal abnormalities (e.g., arachnoid cyst).

scholarly journals Percutaneous peripheral nerve stimulation for treatment of shoulder pain after spinal cord injury: A case report

2017 ◽  
Vol 41 (1) ◽  
pp. 119-124 ◽  
Author(s):  
Daniela Mehech ◽  
Melvin Mejia ◽  
Gregory A. Nemunaitis ◽  
John Chae ◽  
Richard D. Wilson
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Case Report ◽  
Peripheral Nerve ◽  
Shoulder Pain ◽  
Nerve Stimulation ◽  
Peripheral Nerve Stimulation ◽  
Cord Injury

Spinal Cord Stimulation and Peripheral Nerve Stimulation

Pain ◽  
2011 ◽  
pp. 148-154
Author(s):  
Tabitha A. Washington ◽  
Khalilah M. Brown ◽  
Gilbert J. Fanciullo
Keyword(s):  
Spinal Cord ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Spinal Cord Stimulation ◽  
Peripheral Nerve Stimulation
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