Ultrasound-Guided Percutaneous Peripheral Nerve Stimulation for the Treatment of Chronic Intractable Pain Originating From a Lipofibromatous Hamartoma of the Median Nerve

Ferreira‐Dos‐Santos, Guilherme; Hurdle, Mark Friedrich B.; Gupta, Sahil; Ghazi, Salim M.; Trigg, S.D.; Clendenen, Steven R.

doi:10.1016/j.jhsa.2020.06.003

Cited by 4 publications

(5 citation statements)

References 10 publications

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“…An interesting previous study on Martin-Gruber anastomosis, a neural anastomosis between the median and ulnar nerves, showed preserved hand and digital functions following the radical excision of the main trunk of the median nerve [ 15 ]. In addition, there was a case report in 2021 on the management of intractable postoperative chronic pain after the decompression of LFH of the median nerve via percutaneous peripheral nerve stimulation after the sonographic identification of the tumor boundaries, and the 1-year clinical follow-up data showed satisfactory pain reduction [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

10-Year Clinical Follow-Up after Decompression of Lipofibromatous Hamartoma of the Median Nerve in a 3-Year-Old Patient: Case Report and Review of the Literature

Yoo,

Kim,

Cho

et al. 2023

Children

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Lipofibromatous hamartoma, first reported in 1953, is a rare, slowly progressive soft tissue tumor, the characteristics of which include the enlargement of the affected nerve via the epineurial and perineurial proliferation of adipose and fibrous tissues. Out of 200 previously reported cases of lipofibromatous hamartoma of the median nerve, there have been approximately 25 pediatric cases under the age of 18. Herein, we report a case of lipofibromatous hamatoma of the median nerve in a 3-year-old female patient who was surgically decompressed via carpal tunnel release and epineurolysis. The patient was followed-up on an outpatient clinic basis annually with sonographic evaluations, and the postoperative 10th-year follow-up did not show recurrence or any deficits in motor and sensory functions.

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Section: Discussionmentioning

confidence: 99%

10-Year Clinical Follow-Up after Decompression of Lipofibromatous Hamartoma of the Median Nerve in a 3-Year-Old Patient: Case Report and Review of the Literature

Yoo,

Kim,

Cho

et al. 2023

Children

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“…2 ). 11 Several stimulation devices are commercially available, including devices designed for SCS and those designed specifically for PNS. This results in a wide spectrum of implantation techniques that can be accomplished with 2 broad approaches, open or percutaneous, with variations such as PNFS, in which a percutaneous approach is used to place a subcutaneous electrode.…”

Section: Surgical Techniquementioning

confidence: 99%

“…Reprinted with permission (RightsLink License Number 5218290570729) from Ferreira-Dos-Santos et al. 11 …”

Section: Surgical Techniquementioning

confidence: 99%

“…3 ). 11 Using ultrasound-based or landmark-based guidance, a trajectory to the nerve is defined that places the electrode array parallel to the route of the nerve, reducing the risk of lead migration and associated loss of effectiveness as a cylindrical lead in the periphery can retract or advance. With a patient who is awake, sensory paresthesia concordant to the pain region is verified with sensory stimulation parameters; however, in anesthetized patients and/or mixed sensorimotor nerves, motor stimulation parameters (frequency, 1–10 Hz; amplitude, 0.5–2 mA; pulse width, 100–200 μs) can be used to verify capture of the target.…”

Section: Surgical Techniquementioning

confidence: 99%

“…In the bottom portion of the image is the patient programmer, which the patient and the medical staff use to adjust the stimulation parameters after implantation. Reprinted with permission (RightsLink License Number 5218290570729) from Ferreira-Dos-Santos et al11…”

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confidence: 99%

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Upper-Extremity Peripheral Nerve Stimulators

Stewart

Qadri

Daly

2023

Journal of Hand Surgery Global Online

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Chronic pain conditions are some of the most challenging problems upper-extremity surgeons face and often require a multimodal approach including neuromodulation. Peripheral nerve stimulation (PNS) is one of these modalities, delivering electrical stimulation to peripheral axons to modulate the spinal cord and block out nociceptive signals from the extremity. This blockade leads to long-lasting effects in both the peripheral and central nervous systems. Not only does PNS decrease peripheral pain signals but it also decreases the peripheral inflammatory response and assists with central nervous system plasticity for long-term pain control. Although PNS was initially developed in the 1960s, it has been underrepresented in the literature largely due to the advent of spinal cord stimulation and the lack of Food and Drug Administrationeapproved hardware for PNS. However, for upper-extremity pain, PNS provides notable benefits over spinal cord stimulation devices, as PNS allows for safer, more specific, and often more effective pain control. As clinicians attempt to limit narcotic use, therapies such as PNS have been revisited and are gaining popularity. We present a narrative review of PNS; discuss its mechanism of action, indications, and surgical technique; and provide a summary of the available literature for the upper-extremity surgeon. Peripheral nerve stimulation offers a solution for chronic, debilitating pain recalcitrant to other treatment modalities.

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