Peripheral Nerve Field Stimulation Therapy for Patients With Thoracic Pain: A Prospective Study

Mitchell, B.; Verrills, Paul; Vivian, David; DuToit, Neels; Barnard, A.; Sinclair, Chantelle

doi:10.1111/ner.12458

Cited by 6 publications

(4 citation statements)

References 43 publications

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“…pain reduction at 6 mos. 65 pts received combination SCS + PSFS therapy with statistically equivalent VAS score reductions (results not shown here) Mitchell et al. (2016) Prospective case series PNFS 20 Thoracic pain of various etiologies 1 year Baseline NRS avg.…”

Section: Introductionmentioning

confidence: 66%

“…Reviews from the Yakovlev and Burgher groups were followed by two larger prospective observational studies of 60 total patients with lumbosacral pain (n = 40) or thoracic pain (n = 20) ( Kloimstein et al., 2014 ; Mitchell et al., 2016 ). After 6 moths of PSFS, patients with lumbosacral pain reported a mean reduction in pain scores of 44% [baseline VAS 7.6 ± 1.52 (n = 40) to follow-up VAS 4.36 ± 2.31 (n = 28)] ( Kloimstein et al., 2014 ).…”

Section: Resultsmentioning

confidence: 99%

“…After 6 moths of PSFS, patients with lumbosacral pain reported a mean reduction in pain scores of 44% [baseline VAS 7.6 ± 1.52 (n = 40) to follow-up VAS 4.36 ± 2.31 (n = 28)] ( Kloimstein et al., 2014 ). At 1-year follow-up, patients receiving PSFS for thoracic pain reported mean reduction in pain scores of 72% [baseline NRS 7.75 ± 1.4 to follow-up 2.25 ± 2.14 (n = 17)], with 10 (50%) patients able to reduce analgesic consumption ( Mitchell et al., 2016 ).…”

Section: Resultsmentioning

confidence: 99%

“…PSFS may prove particularly useful in targeting regions of pain where conventional SCS use has been shown to be ineffective or limited, including the face, thorax, cervico-dorsal and lumbar areas, and other sacral, abdominal, and inguinal regions ( Reverberi et al., 2009 ). This perceived advantage of peripheral lead placement in PSFS has led to a recent surge in successful reports of its use in treatment of chronic pain of the back ( Table 1 ) ( Burgher et al., 2012 ; D'Ammando et al., 2016 ; Goroszeniuk et al., 2006 ; Kloimstein et al., 2014 ; Krutsch et al., 2008 ; McRoberts et al., 2013 ; Mitchell et al., 2016 ; Ordia and Vaisman, 2009 ; Paicius et al., 2007 ; Reverberi et al., 2009 ; Reverberi et al., 2013 ; Sator-Katzensclager et al., 2010 ; Verrills et al., 2009 ; Verrills et al., 2011 ; Yakovlev et al., 2011 ), face ( Yakovlev and Resch, 2010 ), knee/joints ( McRoberts and Roche, 2010 ), abdomen ( Paicius et al., 2006 ), pelvis ( Tamimi et al., 2008 ), shoulder ( Theodosiadis et al., 2008 ; Tamimi et al., 2009 ), and in cases of refractory angina ( Goroszeniuk et al., 2012 ), post-thoracotomy pain ( Tamimi et al., 2009 ; Theodosiadis et al., 2010 ; D'Ammando et al., 2016 ), and post-operative inguinal pain ( Stinson et al., 2001 ).…”

Section: Introductionmentioning

confidence: 99%

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Peripheral subcutaneous field stimulation for the treatment of spinal cord injury at-level pain: case report, literature review, and 5-year follow-up

Stabingas

Bergman

Patterson

et al. 2020

Heliyon

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Spinal cord injury (SCI) frequently engenders chronic pain which may be classified as occurring above, at, or below the level of injury. Since patients with SCI may have a complex combination of nociceptive and neuropathic pain, pharmacological interventions often fail. Peripheral subcutaneous field stimulation (PSFS) is a novel neuromodulation surgery for pain in which subcutaneous electrodes designed for spinal cord stimulation are placed subcutaneously in a region of pain. We report the case of a 26-year-old man who was an unrestrained driver in a motor vehicle accident and suffered a complete ASIA A spinal cord injury with paraplegia due to a T4 three-column burst fracture. He underwent successful surgical fixation of the fracture (7/27/12) and developed severe at-level SCI-associated pain which failed all conservative measures. After a successful trial, two octrode leads (Abbott Medical, Plano, TX, USA) were placed for PSFS under general anesthesia and were connected to a right flank rechargeable pulse generator (11/6/13). At 60 months postoperative, the patient continues to use the peripheral field stimulation system on a daily basis and reports near complete relief of his at-level spinal cord injury pain. He noted instantaneous relief of his pain once ideal stimulation programming was achieved and has tolerated complete cessation of all narcotic use. His current programming settings are: Frequency of 50 Hz (Hz), Pulse Width of 350 μs (μsec), Amplitude of 0.00 miliamps (mA), Comf of 7.70 mA, and Perc of 4.50 mA. Chronic pain is a challenging and expensive sequela to manage in SCI patients and newer therapies are needed. Our case suggests that SCI at-level pain may respond durably to PSFS and provides the longest published follow-up on a case of PSFS. Peripheral subcutaneous field stimulation remains an investigational treatment for chronic pain syndrome and larger, long-term follow up studies are needed for the FDA and payers to approve this modality.

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