Spinal Cord Stimulation as Alternative Treatment for Chronic Post-Herniorrhaphy Pain

Yakovlev, Alexander E.; Tamimi, Mazin Al; Barolat, Giancarlo; Karasev, S.; Merkulov, Yu A; Resch, Beth E.; Yakovleva, V.

doi:10.1111/j.1525-1403.2010.00276.x

Cited by 31 publications

(25 citation statements)

References 14 publications

(16 reference statements)

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“…A number of reports applying spinal cord stimulation (SCS) at the T7‐T9 levels have indicated some applicability to chronic neuropathic groin pain, in some cases relieving 75% or more . However, a limitation of SCS with groin pain as with all axial pain distributions is that it is extremely difficult to achieve selective coverage of the painful regions; patients may find it necessary to tolerate “a pair of pants” of extraneous paresthesia in order to also capture the relatively discrete painful region.…”

Section: Literature Summary Of Drg Stimulation For Groin Painmentioning

confidence: 99%

Management of Postherniorrhaphy Chronic Neuropathic Groin Pain: A Role for Dorsal Root Ganglion Stimulation

Liem

Mekhail

2016

Pain Practice

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Chronic neuropathic groin pain is a sequela of hernia surgery that occurs at unacceptably high rates, causing widespread impacts on quality of life. Although the medical community is beginning to recognize the role of surgical technique in the initiation and maintenance of postherniorrhaphy neuropathic pain, little information exists regarding pain management strategies for this condition. This review presents a summary of the pain condition state, its treatment options, and treatment recommendations. Both literature review and clinical experience were used to develop a proposed a treatment algorithm for the treatment of postherniorrhaphy pain. The development of chronic pain may be prevented via a number of perioperative measures. For pain that is already established, some surgical approaches including inguinal neurectomy can be effective, in addition to standard pharmacological treatments and local infiltrations. An unmet need may still exist with these options, however, leaving a role for neuromodulation for the treatment of intractable cases. A pain management algorithm for iterative interventions including stimulation of the dorsal root ganglion (DRG) is described. It is expected that cross-disciplinary awareness of surgeons for nonsurgical pain management options in the treatment of chronic neuropathic postherniorrhaphy pain will contribute to better clinical outcomes.

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Section: Literature Summary Of Drg Stimulation For Groin Painmentioning

confidence: 99%

Management of Postherniorrhaphy Chronic Neuropathic Groin Pain: A Role for Dorsal Root Ganglion Stimulation

Liem

Mekhail

2016

Pain Practice

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“…PNFS and SCS are implantable devices that provide pain relief by producing gentle paresthesias in the concordant areas of pain. Multiple case reports or case series of either separate PNFS,104–109 SCS,110–112 or combined PNFS and SCS113 have been published, all with compelling and successful results. Patient selection appears to play a large role in the success of these modalities.…”

Section: Interventional Pain Managementmentioning

confidence: 99%

“…Patient selection appears to play a large role in the success of these modalities. A few authors have recommended a stringent and selective screening process that advocates for the selection of well-motivated and relatively young patients who are not involved in litigation, have success with a pre-implantation trial period, have favorable spinal anatomy (which would improve easier placement of SCS compared with those with unfavorable anatomy or prior spine surgery), and pass a pre-implantation psychiatric evaluation 105,112. Further large-scale studies may allow for improved evidence and strength of recommendation for these two promising modalities.…”

Section: Interventional Pain Managementmentioning

confidence: 99%

Pain control following inguinal herniorrhaphy: current perspectives

Bjurström¹,

Nicol²,

Amid³

et al. 2014

JPR

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Inguinal hernia repair is one of the most common surgeries performed worldwide. With the success of modern hernia repair techniques, recurrence rates have significantly declined, with a lower incidence than the development of chronic postherniorrhaphy inguinal pain (CPIP). The avoidance of CPIP is arguably the most important clinical outcome and has the greatest impact on patient satisfaction, health care utilization, societal cost, and quality of life. The etiology of CPIP is multifactorial, with overlapping neuropathic and nociceptive components contributing to this complex syndrome. Treatment is often challenging, and no definitive treatment algorithm exists. Multidisciplinary management of this complex problem improves outcomes, as treatment must be individualized. Current medical, pharmacologic, interventional, and surgical management strategies are reviewed.

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“…Nevertheless, anatomical variations in the nerve supply to the groin region, which is mainly innervated by a contribution of the three nervesmentioned previously, as well as the development of thick perineural scar tissue, are common causes of PNFS failure. SCS seems to be a safe and cost‐effective treatment for this pain syndrome (9,10).…”

Section: Introductionmentioning

confidence: 99%

Combined Spinal Cord and Peripheral Nerve Field Stimulation for Persistent Post-Herniorrhaphy Pain

Lepski

Vahedi

Tatagiba

et al. 2013

Neuromodulation: Technology at the Neural Interface

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Spinal Cord Stimulation as Alternative Treatment for Chronic Post-Herniorrhaphy Pain

Cited by 31 publications

References 14 publications

Management of Postherniorrhaphy Chronic Neuropathic Groin Pain: A Role for Dorsal Root Ganglion Stimulation

Management of Postherniorrhaphy Chronic Neuropathic Groin Pain: A Role for Dorsal Root Ganglion Stimulation

Pain control following inguinal herniorrhaphy: current perspectives

Combined Spinal Cord and Peripheral Nerve Field Stimulation for Persistent Post-Herniorrhaphy Pain

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