scholarly journals Spinal Cord Stimulation for Treatment of Pain in a Patient with Post Thoracotomy Pain Syndrome

2011 ◽  
Vol 5;14 (5;9) ◽  
pp. 441-445
Author(s):  
Jordan Graybill
Keyword(s):  
Spinal Cord ◽  
Neuropathic Pain ◽  
Case Report ◽  
Spinal Cord Stimulation ◽  
Complete Resolution ◽  
Pain Syndrome ◽  
Steroid Injections ◽  
Presenting Symptoms ◽  
Wide Range ◽  
Electrode Lead

Post Thoracotomy Pain Syndrome (PTPS) is defined as pain that occurs or persists in the area of the thoracotomy incision for at least 2 months following the initial procedure. The true incidence of PTPS is hard to define as literature reports a wide range of occurrence from 5% to 90%. Thoracotomy is associated with a high risk of severe chronic postoperative pain. Presenting symptoms include both neuropathic pain in the area of the incision, as well as myofascial pain commonly in the ipsilateral scapula and shoulder. Pain management can be challenging in these patients. Multiple treatments have been described including conservative treatments with oral nonsteroidal anti-inflammatory drugs (NSAIDs); topically applied, peripherally acting drugs; neuromodulating agents; physical therapy; transcutaneous electrical nerve stimulation as well as more invasive treatments including intercostal nerve blocks, trigger point steroid injections, epidural steroid injections, radiofrequency nerve ablation, cryoablation, and one case report of spinal cord stimulation. Unfortunately, a portion of these patients will have persistent pain in spite of multiple treatment modalities, and in some cases will experience worsening of pain. This case report describes the novel utility and complete resolution of symptoms with spinal cord stimulation (SCS) in treatment of a patient with persistent PTPS. In the operating room, a percutaneous octet electrode lead was placed using sterile technique under fluoroscopic guidance and loss-of-resistance technique. The octet electrode lead was subsequently advanced with the aid of fluoroscopy to the level of the T3 superior endplate just right of midline. The patient’s pain distribution was captured optimally with stimulation at this level. With the assistance of a neurosurgeon, the lead was anchored, tunneled, and connected to a generator, which was implanted over the right iliac crest. The patient tolerated the procedure well with no complications. We report the successful use of SCS as well as complete resolution of symptoms at 4 months follow-up, in a patient with persistent PTPS, which was resistant to other modalities. In conclusion, studies designed to evaluate the effectiveness of SCS for PTPS may be warranted. Key words: post thoracotomy pain syndrome, PTPS, chronic pain, spinal cord stimulation, thoracic pain, neuropathic pain, transcranial magnetic stimulation

First experience with chronic epidural spinal cord stimulation in Khanty-Mansi autonomous okrug — clinical observations

2021 ◽  
Vol LIII (2) ◽  
pp. 94-100
Author(s):  
Olga A. Bondarenko ◽  
Gaspar V. Gavrilov ◽  
Vadim A. Padurets ◽  
Roman V. Kasich
Keyword(s):  
Spinal Cord ◽  
Neuropathic Pain ◽  
Spinal Cord Stimulation ◽  
Pain Syndrome ◽  
Chronic Neuropathic Pain ◽  
Neuropathic Pain Syndrome ◽  
Epidural Stimulation ◽  
Cord Injury ◽  
Epidural Spinal Cord Stimulation ◽  
And Migration

Purpose of the work. The article is devoted to the first experience of epidural stimulation in the Khanty-Mansiysk Autonomous Okrug at the budgetary institution Surgut Clinical Trauma Hospital. Clinical examples are presented for two main indications for the application of this technique (disease of the operated spine, a consequence of spinal cord injury in combination with chronic neuropathic pain syndrome). Research methods. An assessment of the intensity of pain syndrome was given according to a visual analogue scale, the Pain Detect questionnaire; indicators of anxiety, depression on the HADS scale; quality of life according to the Oswestry questionnaire for a follow-up period of 6-12 months in patients with chronic epidural stimulation. Results. A positive assessment of the action during test neurostimulation was 63.3% (38 patients). Of the established permanent systems, a good result was achieved and persisted for 12 months or more in 96% (24 patients). It was necessary to change the stimulation parameters in 13% (3 patients). Revision of permanent systems was performed in 20% (5 patients), due to the progression of the degenerative-dystrophic process of the spine, damage and migration of system elements. Conclusions. Chronic epidural spinal cord stimulation has established itself as a personalized, highly effective, minimally invasive and safe method of treating chronic neuropathic pain syndromes. Multicomponent corrective action is of scientific interest and requires further study.

scholarly journals Spinal cord stimulation in the treatment of neuropathic pain: Current perspectives of indications, cost-effectiveness, complications and results

2017 ◽  
Vol 7 (2) ◽  
pp. 68-79 ◽  
Author(s):  
Bruno Camporeze ◽  
Renata Faria Simm ◽  
Iracema Araújo Estevão ◽  
Luis Roberto Mathias Junior ◽  
Paulo Henrique Pires de Aguiar ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Neuropathic Pain ◽  
Cost Effectiveness ◽  
Literature Review ◽  
Spinal Cord Stimulation ◽  
Pain Syndrome ◽  
Cost Effective ◽  
Medical Conditions ◽  
Reduction Of Pain ◽  
Bibliographic Search

Introduction: The spinal cord stimulation (SCS) has been described as a valuable neuromodulating procedure in the management of chronic and medically untreated neuropathic pain. Although, many studies have discussed the use of this technique, a question still remains regarding its efficacy in different medical conditions with different etiology in the long term. The aim of this paper is to discuss the risks, complications, cost-effectiveness and results of SCS in patients affected by chronic neuropathic pain based on the comprehensive literature review. Methods: Bibliographic search of references from 1950 to 2016 using the databases MEDLINE, LILACS, SciELO, PubMed, and applied language as selection criteria, choosing preferably recent articles written in Portuguese, Spanish or English. Results: Based on literature review, SCS is a safe, reversible, adjustable and nondestructive surgical procedure demonstrating a significant effect in the reduction of pain intensity and improvement in quality of life in these patients. Furthermore, in spite of the initial high cost to its application, SCS has been associated with lower rates of complications and high rates of cost-effectiveness when compared to standard therapies. Conclusion: Although used in medical conditions with different etiology, the procedure is still an effective and a cost-effective approach to neuropathic pain, mainly in patients affected by failed back pain syndrome (FBSS) and complex regional pain syndrome (CRPS).

scholarly journals Spinal Cord Stimulation as a Treatment Option for Refractory Chemotherapy-Induced Peripheral Neuropathy: Case Report

2020 ◽  
Vol 39 (03) ◽  
pp. 228-231 ◽  
Author(s):  
Arthur Lopes ◽  
Kleber Duarte ◽  
Catarina Lins ◽  
Gabriel Kubota ◽  
Valquíria Silva ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Spinal Cord ◽  
Neuropathic Pain ◽  
Case Report ◽  
Peripheral Neuropathy ◽  
Treatment Option ◽  
Spinal Cord Stimulation ◽  
Lower Limbs ◽  
Oncological Diseases ◽  
Good Treatment Option

AbstractColorectal cancer is one of the most common oncological diseases. Chemotherapy is usually recommended as an adjuvant treatment for stage-II, -III, and -IV tumors. Approximately 10% of the patients develop neuropathic pain after chemotherapy, and they may remain refractory despite the administration of drugs that are commonly used to treat neuropathic pain. Spinal cord stimulation is a good treatment option for neuropathic pain of the lower limbs, and it should be trialed in patients with chemotherapy-induced peripheral neuropathy. We report the case of a patient with oxaliplatin-induced neuropathy and neuropathic pain refractory to oral medication who was successfully treated by spinal cord stimulation.

scholarly journals Spinal cord stimulation for complex regional pain syndrome type 1 with dystonia: a case report and discussion of the literature

F1000Research ◽  
2014 ◽  
Vol 3 ◽  
pp. 97 ◽  
Author(s):  
Caroline Voet ◽  
Bernard le Polain de Waroux ◽  
Patrice Forget ◽  
Ronald Deumens ◽  
Etienne Masquelier
Keyword(s):  
Spinal Cord ◽  
Nervous System ◽  
Case Report ◽  
Complex Regional Pain Syndrome ◽  
Spinal Cord Stimulation ◽  
Behavioural Change ◽  
Pain Syndrome ◽  
Social Model ◽  
Syndrome Type

Background: Complex Regional Pain Syndrome type 1 (CRPS-1) is a debilitating chronic pain disorder, the physiopathology of which can lead to dystonia associated with changes in the autonomic, central and peripheral nervous system. An interdisciplinary approach (pharmacological, interventional and psychological therapies in conjunction with a rehabilitation pathway) is central to progress towards pain reduction and restoration of function.Aim: This case report aims to stimulate reflection and development of mechanism-based therapeutic strategies concerning CRPS associated with dystonia.Case description: A 31 year old female CRPS-1 patient presented with dystonia of the right foot following ligamentoplasty for chronic ankle instability. She did not have a satisfactory response to the usual therapies. Multiple anesthetic blocks (popliteal, epidural and intrathecal) were not associated with significant anesthesia and analgesia. Mobilization of the foot by a physiotherapist was not possible. A multidisciplinary approach with psychological support, physiotherapy and spinal cord stimulation (SCS) brought pain relief, rehabilitation and improvement in the quality of life.Conclusion: The present case report demonstrates the occurrence of multilevel (peripheral and central) pathological modifications in the nervous system of a CRPS-1 patient with dystonia. This conclusion is based on the patient’s pain being resistant to anesthetic blocks at different levels and the favourable, at least initially, response to SCS. The importance of the bio-psycho-social model is also suggested, permitting behavioural change.

scholarly journals Spinal cord stimulation for intractable post-thoracotomy pain syndrome - A case report -

2009 ◽  
Vol 57 (5) ◽  
pp. 678
Author(s):  
Heon Keun Lee ◽  
Seung Wha Lee ◽  
Il Woo Shin ◽  
Ju Tae Sohn ◽  
Yeong Ju Jeong ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Spinal Cord Stimulation ◽  
Pain Syndrome

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

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