Peripheral Nerve Field Stimulation: Is Age an Indicator of Outcome?

Verrills, Paul; Mitchell, B.; Vivian, David; Sinclair, Chantelle

doi:10.1111/j.1525-1403.2009.00190.x

Cited by 4 publications

(4 citation statements)

References 21 publications

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“…Per results of these multicenter trials, PNFS can be safe, easy and good treatment option for intractable low back pain patients who are not or have stopped responding to conventional medical and interventional pain management. Although it has been reported ( n = 23) that age above 60 years can contribute to decreased analgesic efficacy of PNFS in chronic pain,[9] the report of 10 cases[5] had three patients aged 80 years and above but nevertheless concluded that 80% patients showed some benefits and 60% patients reported significant improvements[5] with PNFS for SIJ pain. Alternatively, even though PNFS will be the last resort treatment option (due to invasiveness, costs and clinical management/follow-up for standard complications related to implantable neurostimulators) for SIJ pain (diagnosed by default at the time of first-line diagnostic pain interventions),[1] PNFS permanent leads implanted at the most painful area in the lower back area for chronic pain can still provide analgesic efficacy irrespective of whether SIJ pain was confirmed or not confirmed by diagnostic pain intervention (approximately 20% are false-positives anyway)[1] as the underlying cause for chronic low back pain.…”

Section: Discussionmentioning

confidence: 99%

Intractable sacroiliac joint pain treated with peripheral nerve field stimulation

Chakrabortty

Kumar

Gupta

et al. 2016

J Anaesthesiol Clin Pharmacol

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As many as 62% low back pain patients can have sacroiliac joint (SIJ) pain. There is limited (to poor) evidence in regards to long-term pain relief with therapeutic intra-articular injections and/or conventional (heat or pulsed) radiofrequency ablations (RFAs) for SIJ pain. We report our pain-clinic experience with peripheral nerve field stimulation (PNFS) for two patients of intractable SIJ pain. They had reported absence of long-term pain relief (pain relief >50% for at least 2 weeks postinjection and at least 3 months post-RFA) with SIJ injections and SIJ RFAs. Two parallel permanent 8-contact subcutaneous stimulating leads were implanted under the skin overlying their painful SIJ. Adequate stimulation in the entire painful area was confirmed. For implantable pulse generator placement, a separate subcutaneous pocket was made in the upper buttock below the iliac crest level ipsilaterally. During the pain-clinic follow-up period, the patients had reduced their pain medications requirements by half with an additional report of more than 50% improvement in their functional status. The first patient passed away 2 years after the PNFS procedure due to medical causes unrelated to his chronic pain. The second patient has been comfortable with PNFS-induced analgesic regimen during her pain-clinic follow-up during last 5 years. In summary, PNFS can be an effective last resort option for SIJ pain wherein conventional interventional pain techniques have failed, and analgesic medication requirements are escalating or causing unwarranted side-effects.

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Section: Discussionmentioning

confidence: 99%

Intractable sacroiliac joint pain treated with peripheral nerve field stimulation

Chakrabortty

Kumar

Gupta

et al. 2016

J Anaesthesiol Clin Pharmacol

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“…Younger patients may respond better to PNfS than older patients. In a cohort of 23 patients, those over the age of 60 noted an average pain reduction of 2.83 points on the visual analog scale compared to 4.79 in those younger than 60 [20].…”

Section: Failed Back Surgery Syndromementioning

confidence: 98%

Peripheral Nerve Stimulation for the Treatment of Truncal Pain

Cairns¹,

McRoberts

Deer³

2011

Progress in Neurological Surgery

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Neuromodulation practitioners increasingly recognize the potential for peripheral nerve field stimulation (PNfS) to treat pain originating from the trunk. Conditions resulting in truncal pain that may respond to PNfS include cervical and lumbar postlaminectomy syndrome, inguinal neurapraxia, post-herpetic neuralgia, and post-thoracotomy pain. The focus of this chapter is to review the mechanism of action in PNfS, patient selection factors, programming strategies, and technical considerations.

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“…Indications are not well established because therapeutic modalities have sometimes been confusing (2,10–13). One of the greatest confounding points is the use of the terms for stimulating a peripheral nerve directly and the fibers of a nerve as interchangeable.…”

Section: Indicationsmentioning

confidence: 99%