WIRELESS HIGH FREQUENCY SPINAL CORD STIMULATION FOR THE TREATMENT OF POST-HERPETIC OCULAR NEURALGIA: A CASE REPORT

2018 ◽  
pp. 167-171
Author(s):  
Nick Vanquathem
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Minimally Invasive ◽  
Spinal Cord Stimulation ◽  
High Frequency ◽  
Stellate Ganglion ◽  
Pain Clinic ◽  
Post Herpetic Neuralgia ◽  
Vas Score ◽  
Multiple Frequencies

Background: High frequency wireless Spinal Cord Stimulation (SCS) at the C1-C2 vertebral levels provides analgesia for the treatment of refractory ocular pain on the left side secondary to post-herpetic neuralgia. Objective: To assess analgesic effects of minimally invasive wireless neuromodulation in the treatment of chronic pain due to post-herpetic neuralgia. Study Design: This observational, prospective case report was designed to illustrate the effectiveness of relieving chronic, intractable pain utilizing wireless spinal cord stimulation at multiple frequencies for the treatment of post-herpetic neuralgia. Setting: Private Practice Interventional Pain Clinic. Methods: This is a single case study of a 62-yearold patient who experienced an episode of shingles with rash over the left frontal and lateral ocular margin. After the rash subsided, the patient began suffering from severe pain in the left eye. The patient was placed on a 10-day course of valacyclovir, gabapentin, which was discontinued secondary to sedation intolerance, pregabalin titrated to 300 mg/day and oxycodone, all of which were ineffective in relieving the pain. The patient received a stellate ganglion block injection on 6 occasions, experiencing pain relief of only up to one-day after each injection. Stellate ganglion radiofrequency ablation was also unsuccessful. With original Visual Analog Scale (VAS) score of 9/10, inability to sleep and incapacity to perform activities of daily living (ADLs), the patient had Stimwave Freedom wireless stimulators placed sequentially at the C1-C2 vertebral levels. Results: Programming at low frequencies from 40-120 Hz was unsuccessful in reducing left eye pain. Stimulation was increased to high frequency on the Stimwave SurgeTM adjustable waveform, and within 12 hours, the patient noted significant decrease in pain. At 3 days post-procedure, the patient’s VAS score was 1/10. The patient had permanent placement of the devices, and at 8-month follow-up, VAS scores were 0-2/10, and the patient’s mood, sleep and ability to perform ADLs all improved substantially. Limitations: The study was limited by the novelty of the device. Although the doctor who implanted the device is very experienced, more cases of the use of the wireless Stimwave Freedom apparatus are necessary to establish its long-term effectiveness and safety. More clinical trials investigating the utilization of multiple frequencies are also required. Conclusions: Epidural placement of 2, wireless sequentially placed octopolar stimulators with a minimally invasive technique at high frequency stimulation was safe and effective. Key words: post-herpetic neuralgia, ocular, spinal cord stimulation, wireless, shingles, trigeminal nerve, high frequency

scholarly journals High Frequency Spinal Cord Stimulation in a Patient with Bilateral Cochlear Implants

2021 ◽  
pp. 189-191
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Pain Relief ◽  
Cochlear Implant ◽  
Cochlear Implants ◽  
Spinal Cord Stimulation ◽  
High Frequency ◽  
Pain Clinic ◽  
Bilateral Cochlear Implants ◽  
Patient Reported

BACKGROUND: High-frequency spinal cord stimulation (HF-SCS) has become very popular in the management of chronic pain worldwide. As it relies on generating high-frequency electrical impulses, there is a risk of interference with other devices such as cochlear implants that utilize similar principles. A literature search did not reveal any case reports of HF-SCS implantation in a patient with cochlear implants. CASE REPORT: A 75-year-old White woman with a history of bilateral cochlear implants (Cochlear Americas Nucleus® with cp910 processor) for severe sensorineural hearing loss presented to our chronic pain clinic with lumbosacral radiculopathy. The patient underwent a HF-SCS trial with entry point at the L1-L2 space and the leads positioned at the top and bottom of T8. The patient did not experience any auditory interference with her Cochlear implant at triple the average SCS stimulation strength. During the follow-up visit the next week, the patient reported nearly 80% symptomatic pain relief and significant functional improvement. There was no change in her hearing and no evidence of interference. The patient ultimately underwent percutaneous SCS paddle electrode placement and at 3 months, continues to have excellent pain relief without any auditory interactions. CONCLUSION: We successfully implanted a HF-SCS at the thoracic level in a patient with bilateral cochlear implants without any auditory interference. KEY WORDS: Cochlear implant, lumbar radiculopathy, spinal cord stimulation

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-frequency spinal cord stimulation in failed back surgery syndrome patients with predominant low back pain—single-center experience

2021 ◽  
Author(s):  
Stefan Motov ◽  
Kaywan Aftahy ◽  
Ann-Kathrin Jörger ◽  
Arthur Wagner ◽  
Bernhard Meyer ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Low Back Pain ◽  
Back Pain ◽  
Spinal Cord Stimulation ◽  
High Frequency ◽  
Failed Back Surgery Syndrome ◽  
Low Back ◽  
Vas Score ◽  
Failed Back Surgery ◽  
Back Surgery

AbstractTreatment of patients with failed back surgery syndrome (FBSS) with predominant low back pain (LBP) remains challenging. High-frequency spinal cord stimulation (HF10 SCS) is believed to achieve significant pain reduction. We aimed to evaluate the real-life efficacy of HF-10 SCS in a tertiary spine center. A prospective observational study of all patients with FBSS and predominant LBP who underwent HF-10 SCS surgery was performed between 2016 and 2018. Patients > 18 years with Visual Analogue Scale (VAS) scores of ≥ 5 for LBP and pain duration > 6 months under stable medication were implanted percutaneous under general anesthesia and a trial phase of 7–14 days was accomplished. Primary end point was a successful trial defined as ≥ 50% VAS score reduction for LBP. Thirty-four of 39 (85%) subjects had a successful trial. Fifty-three percent were female and the mean age was 69 years. Median follow-up lasted for 10 months. Devices were removed after a median of 10 months in 5 cases. Remaining 29 patients stated significant VAS score reduction for LBP from 8.1 to 2.9 and VAS for leg pain from 4.9 to 2.2. Twenty-four percent of all patients were able to discontinue their opioids. Eight of 9 patients (89%) with signs of adjacent disc disease and 7 of 10 (70%) patients with hardware failure were successfully implanted with significant VAS reduction for LBP. HF-10 SCS achieves significant pain reduction in most patients with FBSS and predominant LBP. It might be an efficient alternative to revision surgery.

scholarly journals High-frequency spinal cord stimulation causing cardiac paresthesias after lead migration: a case report

2018 ◽  
Vol 12 (4) ◽  
pp. 217-219 ◽  
Author(s):  
Neil Majmundar ◽  
Eleonora Francesca Spinazzi ◽  
Joseph Doran ◽  
Antonios Mammis
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Pain Relief ◽  
Spinal Cord Stimulation ◽  
High Frequency ◽  
Treatment Interruption ◽  
Adverse Outcomes ◽  
Leg Pain ◽  
Novel Therapy ◽  
Left Chest

Introduction: High-frequency (HF) spinal cord stimulation (SCS), a relatively new form of spinal cord stimulation, provides stimulation frequencies of up to 10 kHz and allows for paresthesia-free pain relief, an advantage that distinguishes it from traditional stimulation therapy. Without paresthesias, patients with HF SCS do not experience position-dependent painful stimulation and do not have to experience treatment interruption during sleep. Lead migration is a well-known complication of conventional spinal cord stimulation and usually results in a loss of efficacy along with other unpleasant sensory symptoms. In this case report, we present an incidence of lead migration in HF SCS that resulted in paresthesias, a symptom not expected to occur in this novel therapy. Case: The patient, a 60-year-old female with post-laminectomy syndrome, underwent a trial of HF SCS with standard lead placement at T8-T9. She initially had pain relief, but returned to the office on post-operative day 2 complaining of left chest wall and cardiac paresthesias, without frank pain or palpitations, in addition to loss of efficacy for her back and leg pain. Imaging showed that the leads had migrated, with one lead reaching the levels of T1-T3. Conclusion: While HF SCS has emerged as an effective paresthesia-free means of reducing back and leg pain, we provide the first report of paresthesias occurring with the HF SCS system as a result of cephalad lead migration. As HF SCS is only now being utilized as a treatment modality, we must remain cautious of potential adverse outcomes in patients, in particular above T8.

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