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 Trigeminal and occipital peripheral nerve stimulation for craniofacial pain: a single-institution experience and review of the literature

2006 ◽  
Vol 21 (6) ◽  
pp. 1-5 ◽  
Author(s):  
Konstantin V. Slavin ◽  
M. Efkan Colpan ◽  
Naureen Munawar ◽  
Christian Wess ◽  
Hrachya Nersesyan
Keyword(s):  
Neuropathic Pain ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Peripheral Nerve Stimulation ◽  
Long Term Results ◽  
Treatment Modalities ◽  
Surgical Approaches ◽  
Published Data ◽  
Pain Location ◽  
Craniofacial Pain

Object Treatment of chronic neuropathic pain in the region of the head and face presents a challenge for pain specialists; patients who do not respond to conventional treatment modalities usually continue to suffer from pain due to the lack of reliable medical and surgical approaches. Peripheral nerve stimulation (PNS) has been used to treat neuropathic pain for many decades, but only recently has it been applied systematically to the craniofacial region. To advance the study of this treatment option, the authors present their initial experience with this approach, summarize published data on the use of PNS in treatment of craniofacial pain, and discuss some technical details of the craniofacial PNS procedure. Methods A review of prospectively collected data in 30 patients who underwent PNS surgery for craniofacial pain was performed. The pain location, duration, cause, and previous treatments were analyzed, along with the surgical details, initial and long-term results, complications, and repeated operations. Stimulated nerves in this group included supraorbital (seven patients), infraorbital (six), and occipital (21); in 19 patients more than one nerve was stimulated. Twenty-two patients proceeded with implantation of a permanent system after the trial. Of these, at the time of the latest evaluation (mean follow-up duration 35 months), in two patients the devices had been removed because of pain improvement over time, in three the devices were removed due to loss of effectiveness (two cases) or late infection (one), and the rest are enjoying either complete (15 patients) or partial (two patients) pain relief. Three patients underwent repeated operation due to lead erosion, infection, or migration. Conclusions Peripheral nerve stimulation appears to be a safe and effective approach in the treatment of craniofacial neuropathic pain. The growing body of literature supports a wider acceptance of this approach in the field of pain surgery.

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 &lt; .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 &lt; .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 &lt; .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.

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

Anatomic substrate of analgesia produced by long-term peripheral nerve stimulation in patients with neuropathic pain: a PET activation study

2007 ◽  
Vol 68 (2) ◽  
pp. 201
Author(s):  
F. Van Calenbergh ◽  
K. Van Laere ◽  
B. Depreitere ◽  
J. Gybels ◽  
L. Plaghki ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Peripheral Nerve Stimulation
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