Regression of chronic pain syndrome refractory to opioid pharmacotherapy in a patient after implantation of a spinal cord neurostimulator: case report

Abstract

BACKGROUND: Pain in cancer patients, often poorly treated, cause severe distress for patients and their caregivers, and significantly reduces quality of life. Modern guides for the medical treatment of chronic pain in cancer patients are not effective in all cases, especially when chronic neuropathic pain syndrome occurs. In this regard, there is a need for a multidisciplinary personalized approach to the tactics of chronic pain management in favor of surgical methods at earlier stages of this condition. Nowadays neuromodulation is widely used for the treatment of neuropathic chronic pain syndrome in patients with various pathologies, whereas it is not used routinely in cancer patients.
 CLINICAL CASE DESCRIPTION: We introduce a case report of successfully applied neuromodulation in patient with severe chronic pain syndrome due to rectal cancer. Epidural spinal cord stimulation at Th10Th12 levels allowed to stop the systemic use of opioids and achieve long-term remission. Spinal cord stimulation has shown itself to be very promising and significantly improved patients quality of life.
 CONCLUSIONS: Our case report evidently shows that current chronic pain management guides and treatment recommendations needs a revision and neuromodulation usage in category of cancer patients should be considered.