Successful peripheral nerve field stimulation for thoracic radiculitis following Brown-Sequard syndrome.
Neuromodulation
; 14(3): 249-52; discussion 252, 2011.
Article
em En
| MEDLINE
| ID: mdl-21992248
ABSTRACT
OBJECTIVE:
The objective of this study is to present a novel approach to the treatment of thoracic radiculitis following Brown-Sequard syndrome with peripheral nerve field stimulation (PNFS). Furthermore, we endeavor to discuss the role of PNFS in the management of refractory neuropathic pain conditions including post-traumatic and post-surgical neuropathy particularly with regards to the post-surgical spine. MATERIALS ANDMETHODS:
Presented is a 57-year-old man with history of thoracic microdiscectomy resulting in Brown-Sequard syndrome presented with chronic post-operative thoracic radicular pain radiating to the abdomen, refractory to conservative management. The patient underwent three intercostal nerve blocks from T7 to T9 with transient symptomatic relief. The patient's options were limited to chemomodulation, neuromodulation, or selective intercostal nerve surgical neurectomy. He subsequently underwent a PNFS trial and reported >75% pain reduction. Permanent percutaneous PNFS electrodes were implanted subcutaneously over the right T7 and T9 intercostal nerves and replicated the trial results.RESULTS:
Neuromodulation produced pain relief with >90% improvement in pain compared with baseline both during the trial and following permanent implantation of the PNFS system.CONCLUSION:
Chronic radicular pain may be difficult to manage in the post-surgical patient and often requires the use of multiple therapeutic modalities. In this case, we successfully utilized PNFS as it demonstrated greater technical feasibility when compared with dorsal column stimulation and repeat surgery; therefore, it may be considered for the management of post-surgical neuropathy. Further controlled studies are needed to evaluate the efficacy of PNFS as a treatment option.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Nervos Periféricos
/
Radiculopatia
/
Vértebras Torácicas
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Terapia por Estimulação Elétrica
/
Síndrome de Brown-Séquard
Limite:
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Neuromodulation
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Estados Unidos