Peripheral Nerve Stimulation for Treatment of Cluneal Neuropathy Case Study

Abstract

Chronic low back pain is a prevalent and sometimes debilitating condition. This case report describes a 69year-old female presenting with axial spine pain. The pain was inadequately controlled by opioids as she was treated unsuccessfully with hydrocodone and remained to have the pain between 7/10 and 10/10. Peripheral neural stimulation (PNS) was trialed and then used to control her pain. PNS is a device-based treatment option that appears effective in a subset of patients. It has been effectively used to treat many different chronic pain syndromes. The patient responded well to the treatment, with her pain intensity going down to between 2/10 and 5/10 on the same scale. She was able to discontinue her use of opioids. PNS can be a safe and effective treatment in patients who have not responded well to pharmacologic analgesia.

Stimulating Superior Cluneal Nerves via Peripheral Nerve Stimulation as a Treatment for Chronic Low Back Pain

“…Historically, surgical decompression may be considered, targeting either the distal superior cluneal nerve branches or the involved lumbar radicular segments [3,4]. To reduce invasive therapies, previous case reports have shown that permanent PNS can provide relief for refractory SCN-induced LBP [5][6][7]. This case expands the option for SCN-induced LBP via a 60-day temporary PNS system, broadening the repertoire for patient care for sustained analgesic benefits compared to a permanent PNS system.…”

Peripheral Nerve Stimulation for the Treatment of Superior Cluneal Neuralgia: A Cadaver Demonstration of a Novel Technique for Lead Placement

“…They both demonstrated a refractory SCN case that was successfully treated with PNS. 11,12 Novel Approach to PNS for SCN In this section we will demonstrate a novel approach to placing a peripheral nerve stimulator for the superior cluneal nerve using a cadaver model and compare this new method to the current standard. This was a cadaveric study where placement was performed on a cadaver using fluoroscopic guidance with saving images to demonstrate all steps for placing a peripheral nerve stimulator introducer and lead.…”