Peripheral Nerve Stimulation for Lower Extremity Pain

Busch, Clayton; Smith, Olivia M.; Weaver, Tristan; Vallabh, Jayesh C; Abd‐Elsayed, Alaa

doi:10.3390/biomedicines10071666

Cited by 11 publications

(4 citation statements)

References 58 publications

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“…Several studies have demonstrated a significant improvement in pain scores post-PNS implantation with a growing variety of implant locations being evaluated. This includes PNS therapy for low back pain, lower extremities, headaches, and even phantom limb pain [16][17][18][19][20][21]. In a retrospective study of 72 patients who underwent PNS therapy, pain scores and opioid utilization to manage pain improved within 6 months after implantation [22].…”

Section: Brief Summary and Published Data Comparisonmentioning

confidence: 99%

Temporary Peripheral Nerve Stimulation as Treatment for Chronic Pain

Abd-Elsayed,

Keith,

Cao

et al. 2023

Pain Ther

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Introduction Chronic pain is a growing problem across the world, and in the midst of an opioid epidemic, it is imperative that alternative treatment measures are identified to help alleviate the pain experienced by these patients. Chronic pain greatly affects ones quality of life and many patients do not experience adequate relief with conventional treatment measures. The purpose of this retrospective analysis is to assess the efficacy of peripheral nerve stimulation (PNS) therapy in adult patients suffering from chronic pain refractory to conventional treatment measures who underwent therapy on various anatomical locations. Methods This retrospective analysis consisted of data collected from electronic health records for n = 89 patients who underwent PNS therapy. Data collected relates to patient age, sex, weight, height, body mass index (BMI), diagnosis, targeted nerves, follow-up encounters, pain scores from before and after PNS therapy, and duration of improvement. Statistical analysis used SPSS software, version 26 (IBM), using a paired t test to assess significance between pre and post PNS therapy pain scores. P values were significant if found to be ≤ 0.05. Further analysis assessed the correlation between age and BMI with visual analog scale (VAS) pain improvement and subjective percentage pain relief. Results The mean pre-operative (pre-op) pain score before PNS therapy was 6.36 (standard deviation (SD) = 2.18, SEM = 0.23) and the mean post-operative (post-op) pain score after PNS therapy was 4.19 (SD = 2.70, SEM = 0.29). The mean patient-reported percent improvement in pain following PNS therapy was 49.04% (SD = 34.79). The improvement in pain scores between pre-op and post-op was statistically significant (M = 2.17, SD = 2.82, SEM = 0.30, t (88) = 7.26, p < .001), 95% confidence interval (CI) [1.57, 2.76]. The mean duration of improvement for patients was 123 days after therapy initiation (min = 6, max = 683, SD = 126). Conclusions This study demonstrated the potential role for PNS therapy in improving patient-reported pain levels for various neuropathies, targeting various nerves. With PNS therapy’s use as a chronic pain treatment and available research being limited, further study needs to be done on the efficacy of PNS therapy for pain management and complications associated with PNS device placements at various locations.

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Section: Brief Summary and Published Data Comparisonmentioning

confidence: 99%

Temporary Peripheral Nerve Stimulation as Treatment for Chronic Pain

Abd-Elsayed,

Keith,

Cao

et al. 2023

Pain Ther

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“…Peripheral nerve injuries resulting from trauma or disease are often detrimental and can lead to chronic disabilities [ 3 ]. Patients with peripheral nerve injuries frequently suffer from sensorimotor deficits and neuropathic pain [ 4 , 5 ]. In addition to physical symptoms, patients with peripheral nerve injuries may also suffer from psychological symptoms, including depression and decreased self-efficacy [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Neuromodulation for Peripheral Nerve Regeneration: Systematic Review of Mechanisms and In Vivo Highlights

et al. 2023

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While denervation can occur with aging, peripheral nerve injuries are debilitating and often leads to a loss of function and neuropathic pain. Although injured peripheral nerves can regenerate and reinnervate their targets, this process is slow and directionless. There is some evidence supporting the use of neuromodulation to enhance the regeneration of peripheral nerves. This systematic review reported on the underlying mechanisms that allow neuromodulation to aid peripheral nerve regeneration and highlighted important in vivo studies that demonstrate its efficacy. Studies were identified from PubMed (inception through September 2022) and the results were synthesized qualitatively. Included studies were required to contain content related to peripheral nerve regeneration and some form of neuromodulation. Studies reporting in vivo highlights were subject to a risk of bias assessment using the Cochrane Risk of Bias tool. The results of 52 studies indicate that neuromodulation enhances natural peripheral nerve regeneration processes, but still requires other interventions (e.g., conduits) to control the direction of reinnervation. Additional human studies are warranted to verify the applicability of animal studies and to determine how neuromodulation can be optimized for the greatest functional restoration.

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“…14 This technique was much less invasive than previous procedures and was shown in the coming years to effectively treat many conditions such as lower back, groin, ankle, neck, and abdominal pain along with migraines and CRPS type 2. [15][16][17][18][19][20][21][22][23][24][25][26] This article presents a collection of cases comparing patient-reported pain scores before and after the implant at various sites of a percutaneous peripheral nerve stimulation lead/s with an external generator.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Peripheral Nerve Stimulation with a High Frequency Electromagnetic Coupled (HF-EMC) Powered Implanted Receiver in Treating Different Pain Targets/Neuralgias

Abd‐Elsayed¹,

Moghim²

2023

JPR

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Introduction Chronic pain is a significant global public health problem. Peripheral nerve stimulation (PNS) has been gaining popularity in recent years as it is effective, safe and less invasive than surgery for the treatment of chronic pain. The authors aimed to document and share a collection of patient-reported pain scores before and after implanting a percutaneous PNS lead/s with an external wireless generator at various target nerves. Methods The authors designed a retrospective study, reviewing electronic medical records. Statistical analysis was performed using SPSS 26; p-value ≤ 0.05 was considered significant. Results The mean baseline pain scores of 57 patients have reduced significantly after the procedure at different follow-up durations. Target nerves included genicular nerves, superior cluneal nerves, posterior tibial nerve ± sural nerve, middle cluneal nerves, radial and ulnar nerves and right common peroneal nerve. In the one-month follow-up group, mean pain score was reduced from 7.44 ± 1.48 pre-procedure to 1.6 ± 1.49, from 7.42 ± 1.5 pre-procedure to 1.6 ± 1.5 7.42 at 3 months, from 7.52 ± 1.5 to 1.72 ± 1.57 at 6 months, from 7.41 ± 1.53 to 1.7 ± 1.55 at 9 months, from 7.41 ± 1.58 to 1.76 ± 1.63 at 12 months, from 7.38 ± 1.59 to 1.69 ± 1.56 at 15 months and from 7.5 ± 1.7 to 1.45 ± 1.57 at 24 months (p ≤ 0.001). Patients also reported significant reduction in morphine milliequivalent, pre-procedure MME 47.75 ± 452.5 to 37.92 ± 43.51 at 6 months (p = 0.002, N = 57), pre-procedure MME 42.72 ± 43.19 to 30.38 ± 41.62 at 12 months (p = 0.003, N = 42), and pre-procedure MME 41.2 ± 46.12 to 21.19 ± 40.88 at 24 months (p ≤ 0.001, N = 27). The only complications occurred post procedure with 2 patients receiving an explant and 1 patient receiving a lead migration. Conclusion PNS has been shown to be safe and effective in treating chronic pain at different sites with sustained pain relief for up to 24 months. This study is unique in providing long-term follow-up data.

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Peripheral Nerve Stimulation for Lower Extremity Pain

Cited by 11 publications

References 58 publications

Temporary Peripheral Nerve Stimulation as Treatment for Chronic Pain

Temporary Peripheral Nerve Stimulation as Treatment for Chronic Pain

Neuromodulation for Peripheral Nerve Regeneration: Systematic Review of Mechanisms and In Vivo Highlights

Efficacy of Peripheral Nerve Stimulation with a High Frequency Electromagnetic Coupled (HF-EMC) Powered Implanted Receiver in Treating Different Pain Targets/Neuralgias

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