Ultrasound‐Guided Percutaneous Peripheral Nerve Stimulation for the Treatment of Lower Extremity Pain: A Rare Case Report

Abstract

Objective This case report presents an application of percutaneous peripheral nerve stimulation to the right superficial peroneal nerve to treat a patient with chronic intractable L5–S1 radiculopathy pain that conventional treatment failed to ameliorate. Methods The patient underwent an uneventful implantation of a percutaneous peripheral nerve stimulator. The implanted lead (15 cm in length and 1.2 mm in diameter) containing the receiver coil and 3 stimulation electrodes (Bioness Stimrouter®, Valencia, CA, U.S.A.) was implanted parallel with the trajectory of the right superficial peroneal nerve. Results Two weeks after implantation of the percutaneous peripheral nerve stimulator, the patient experienced excellent pain relief and reported a significant increase in mobility. At the 3‐month follow‐up consultation, the patient reported maintenance of the reduction of pain in his right lower extremity as well as improved performance in his daily activities. Conclusion Percutaneous peripheral nerve stimulation offers an alternative treatment option for intractable pain associated with chronic radiculopathy, especially for patients in whom conventional treatment options have been exhausted. Further clinical series involving larger numbers of patients are warranted in order to assess the definitive role of percutaneous peripheral nerve stimulation for the treatment of chronic intractable radiculopathy pain.

Ultrasound-Guided Percutaneous Neuromodulation in Patients with Unilateral Anterior Knee Pain: A Randomized Clinical Trial

“…The use of ultrasound has allowed the development of percutaneous peripheral nerve stimulation. On the one hand, some therapists implant a percutaneous peripheral nerve stimulator to manage chronic pain, such as radiculopathy pain [32], neuropathic postamputation pain [33], or low back pain [34]. On the other hand, other clinicians use the US-guided PNM that allows for applying PES in close proximity to the nerve, with ultrasound guidance [13].…”

Ultrasound-guided Percutaneous Peripheral Nerve Stimulation for the Treatment of Complex Regional Pain Syndrome Type 1 Following a Crush Injury to the Fifth Digit: A Rare Case Report

“…This nonpainful stimulation provided by PNS inhibits these interneurons, thereby decreasing or even interrupting the transmission of pain signals [6][7]. Moreover, some studies have suggested that PNS may also directly change the excitability of peripheral nerve fibers, increasing the threshold for nociceptive stimulation to occur [6][7][8][9]. Some previous studies have also suggested that this direct peripheral inhibition could happen through an alteration in the local concentrations of biochemical mediators that augment the pain response.…”

“…Over the last 5 years, it has been gaining momentum in terms of the development of new indications as well as with regard to the accumulation of clinical experience. It may even be particularly effective either as an adjuvant to spinal cord stimulation (SCS) or as a stand-alone therapy when the pain is localized to a part of a single extremity [6][7][8][9].…”

Effects of Ultrasound-Guided Nerve Stimulation Targeting Peripheral Nerve Tissue on Pain and Function: A Scoping Review

“…After extensive reading, 12 studies were excluded. Therefore, a total of eighteen (n = 18) studies [10][11][12][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] were included in the literature data mapping (Figure 1).…”

“…From six experimental studies, five were randomized controlled trials [11,36,37,47,49] and one was a trial protocol [12] reporting no results. Thus, nine studies were case series [10,35,39,[41][42][43]45,46,48] and three articles described case reports [38,40,44].…”