scholarly journals Successful integration of interdisciplinary pain rehabilitation and spinal cord stimulation for chronic naive back pain

2021 ◽  
Vol 6 (10) ◽  
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Back Pain ◽  
Case Report ◽  
Spinal Cord Stimulation ◽  
Interventional Procedure ◽  
Therapeutic Option ◽  
Rehabilitation Program ◽  
Stimulation Parameters ◽  
Successful Integration

Spinal cord stimulation for naive back pain is a therapeutic option that is rarely considered, especially when conventional stimulation parameters are used. Interdisciplinary pain rehabilitation program is another less feasible but effective therapeutic approach for the management of chronic pain that is not usually used in conjunction with interventional procedures.This case report presents a successful integration of an interdisciplinary pain rehabilitation program with an interventional procedure spinal cord stimulation using conventional stimulation parameters in a patient with chronic, predominantly nociceptive to nociplastic, naïve back pain.

scholarly journals Acute thoracic disc heralded by change in spinal cord stimulation pattern: illustrative case

2021 ◽  
Vol 2 (20) ◽  
Author(s):  
Faraz Behzadi ◽  
Edvin Telemi ◽  
Tarek R. Mansour ◽  
Thomas M. Zervos ◽  
Muwaffak M. Abdulhak ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Back Pain ◽  
Spinal Cord Stimulation ◽  
Chronic Back Pain ◽  
Cord Compression ◽  
Illustrative Case ◽  
Disc Protrusion ◽  
Stimulation Parameters ◽  
Spine Pathology ◽  
Thoracic Disc

BACKGROUND Spinal cord stimulation (SCS) uses unique electric stimulation parameters to selectively treat specific regions of chronic or refractory back pain. Changing these parameters can lead to spreading paresthesia and/or pain beyond the desired region. OBSERVATIONS A patient with a history of stable, successful SCS treatment presented with acute development of paresthesias that were relieved by reduction of stimulation parameters. The patient required paradoxically lower SCS settings for control of chronic back pain. This presentation prompted further investigation, which revealed a new disc protrusion and cord compression at the level of the paddle lead. LESSONS In patients with SCS, a new onset of back pain accompanied by acute paresthesia that is reversible by reducing the SCS amplitude warrants investigation for new spine pathology.

Combined Paresthesia and Subperception Spinal Cord Stimulator Therapy for Management of Persistent Pain After Spinal Fusion Surgery for Congenital Scoliosis

2021 ◽  
pp. 33-36
Author(s):  
James C. Burns
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Back Pain ◽  
Case Report ◽  
Spinal Fusion ◽  
Congenital Scoliosis ◽  
Low Back ◽  
Spinal Cord Stimulator ◽  
Fusion Surgery ◽  
Spinal Fusion Surgery

Background: A significant number of patients who undergo spinal fusion surgery are managed in chronic pain clinics for low back pain or what is commonly described as failed back surgery syndrome (FBSS). There are a multitude of reasons for chronic long standing back pain after surgery, and the etiology is often multifactorial involving both preoperative and postoperative risk factors. In patients with scoliosis, it has been shown that fusion with Harrington rods extending into the lumbar region is associated with increases in postoperative back pain, especially with fusions to the L4-L5 region. Spinal cord stimulation (SCS) is a recognized treatment for this condition after repeat surgery or when conservative treatments have failed. Case Report: This case report describes the use of SCS with combination therapy in the management of severe low back pain after thoracolumbar fusion with Harrington rods in a patient with congenital scoliosis. After a failed trial of conservative medical management, a spinal cord stimulator capable of delivering combination traditional paresthesia with subperception and burst stimulation was placed. Regarding the choice of SCS therapy, there is a vast array of choices including traditional paresthesia, paresthesia-free, subperception, microburst, or combination treatment. The latter is capable of delivering multiple therapies over time designed to provide more thorough and longer-lasting relief. Conclusion: Simultaneous traditional paresthesia and subperception waveform therapy might offer superior pain relief in comparison to therapies utilizing a sing=le waveform. Further studies are needed to evaluate the use of combination over traditional SCS therapy for the treatment of axial back pain secondary to FBSS. Key words: Chronic pain, combination therapy, congenital scoliosis, neuromodulation, spinal cord stimulator, spinal fusion

Novel Spinal Cord Stimulation Parameters in Patients with Predominant Back Pain

2013 ◽  
Vol 16 (4) ◽  
pp. 370-375 ◽  
Author(s):  
Jeffrey Tiede ◽  
Lora Brown ◽  
Gennady Gekht ◽  
Ricardo Vallejo ◽  
Thomas Yearwood ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Back Pain ◽  
Spinal Cord Stimulation ◽  
Stimulation Parameters

scholarly journals High Frequency Spinal Cord Stimulation for Complex Regional Pain Syndrome: A Case Report

2017 ◽  
Vol 1 (21;1) ◽  
pp. E177-E182
Author(s):  
Alan D. Kaye
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Complex Regional Pain Syndrome ◽  
Spinal Cord Stimulation ◽  
High Frequency ◽  
Therapeutic Option ◽  
Low Frequency ◽  
Pain Syndrome ◽  
Leg Pain ◽  
Caucasian Woman

Complex regional pain syndrome (CRPS) is a chronic, debilitating, neuropathic pain condition which is often misdiagnosed, difficult to manage, and lacks proven methods for remission. Most available methods provide some relief to a small percentage of patients. Recent FDA approval and superiority of the Nevro Senza 10-kHz high frequency (HF10) spinal cord stimulation (SCS) therapy over traditional low-frequency spinal cord stimulation for treatment of chronic back and leg pain may provide a new interventional therapeutic option for patients suffering from CRPS. We provide a case report of a 53-year-old Caucasian woman who suffered with CRPS in the right knee and thigh for over 7 years. Implantation of the HF10 device provided over 75% relief of pain, erythema, heat, swelling, and tissue necrosis to the entire region within 1 month of treatment. Because the HP10 therapy provides pain relief without paresthesia typical of traditional low-frequency, this system may provide relief for patients suffering from chronic pain. Key words: Complex regional pain syndrome, spinal cord stimulation, Nevro Senza HF10, erythema, knee, thigh

scholarly journals High Level of Childhood Trauma Predicts a Poor Response to Spinal Cord Stimulation in Chronic Neuropathic Pain

2019 ◽  
Vol 1 (22;1) ◽  
pp. E37-E44
Author(s):  
Jaakko Määttä
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Neuropathic Pain ◽  
Risk Factor ◽  
Back Pain ◽  
Childhood Trauma ◽  
Spinal Cord Stimulation ◽  
Post Surgery ◽  
Distress Scale ◽  
Trauma Group

Background: Spinal cord stimulation (SCS) relieves pain by delivering doses of electric current to the dorsal column of the spinal cord and has been found to be most effective in the treatment of neuropathic pain. Psychological distress is a significant risk factor for the development of chronic pain and has been found to affect the outcome of SCS. Childhood trauma is a risk factor for chronic pain, but has not previously been studied in SCS patients. Objectives: The objective of this prospective registry-based study was to investigate the prevalence of 5 domains of childhood trauma (emotional neglect, emotional abuse, physical neglect, physical abuse, and sexual abuse) and their relationship with the outcome of spinal cord stimulation on patients suffering from treatment-resistant chronic pain. Methods: SCS patients treated at Kuopio University Hospital between 1/1/2015 and 12/31/2016 were sent a survey in the mail, the Trauma and Distress Scale, assessing childhood trauma (n = 43). Neuropathic pain, disability, anxiety, and depression were measured in the patients pre-surgery and at 6 and 12 months post-surgery. The patients who provided their name on the questionnaire (n = 22) and had suffered from 3 or more domains of trauma were grouped as the high-trauma group (n = 13) and the rest as the low-trauma group (n = 9). Results: The questionnaire was completed by 40 patients (93%). At least 1 domain of trauma was experienced by 35 (88%) patients, and at least 2 by 24 (60%). The low-trauma group displayed a statistically significant decrease in the mean PainDETECT score from 21.5 before SCS to 16.5 at 12 months post-surgery (Wilk’s lambda = 0.297, F(2,9) = 10.6, P = 0.004), contrary to the hightrauma group (Wilk’s lambda = 0.904, F(2,6) = 0.3, P = 0.739). Limitations: Only 22 of the 40 patients provided their name on the questionnaire, which decreased the sample size on follow-up. Conclusion: This was the first study to investigate childhood trauma in SCS patients. Patients who had experienced high amounts of childhood trauma did not experience any relief from neuropathic pain 12 months’ post-SCS, contrary to the low-trauma group. Childhood trauma might be a factor worth screening in the preoperative evaluation and aftercare of SCS candidates. Key words: Spinal cord stimulation, the Trauma and Distress Scale, chronic pain, childhood trauma, childhood abuse, childhood neglect, chronic back pain, back pain, psychological distress, neuropathic pain

scholarly journals Spinal Cord Stimulation for Chronic Pain Originating from Lyme Disease

2012 ◽  
Vol 6;15 (6;12) ◽  
pp. 511-514
Author(s):  
Yongjie Li
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Case Report ◽  
Pain Management ◽  
Lyme Disease ◽  
Spinal Cord Stimulation ◽  
Single Case ◽  
Management Options ◽  
Single Case Report ◽  
Patient Reported

Background: Neuropathic pain is a relatively common outcome of Lyme disease. Pain management options for these patients have been limited to pharmaceutical treatments. Objective: We present a case of chronic pain following Lyme disease treated successfully using spinal cord stimulation (SCS). Study Design: Case report. Setting: Pain management clinic. Methods: A 62-year-old patient presented with a 5-year history of bilateral foot pain following Lyme disease that failed to respond to medication and physical therapy. The patient was treated by a trial of SCS at the clinic and then implanted with a spinal cord stimulator. The Visual Analog Scale (VAS) assessed pain before and after SCS. Results: The patient reported significant pain relief and improved foot function. The 10 point VAS score was reduced from 8−10 to 1–3. Limitations: Single case report. Conclusion: Spinal cord stimulation may be an effective option for relieving chronic pain originating from Lyme disease. Key words: Spinal cord stimulation, Lyme disease, chronic pain.

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