Use of Peripheral Subcutaneous Field Stimulation for the Treatment of Axial Neck Pain: A Case Report

Peripheral Nerve Stimulation for the Treatment of Truncal Pain

“…Although long-term data are not available, Krutsch et al [19] reported a single patient with lumbar FBSS who had 90% improvement at 12 months postimplant. Report of improvement of discogenic pain after cervical surgery has also been reported with 100% relief of a single patient at 9 months follow-up [5]. Retrograde placement of leads near the lumbar and sacral nerve roots has also been reported as a treatment for patients with FBSS although technical challenges and inability to obtain paresthesia in the low back have limited its widespread use.…”

“…Patients considered for PNfS trials have failed traditional interventional spinal procedures such as epidural steroid injections, medial branch blocks, facet joint nerve ablations, SI injections, and in many cases surgery. Conditions resulting in truncal pain that have been reported to respond to PNfS are lumbar postlaminectomy syndrome, axial cervical pain, PHN, inguinal pain, ilioinguinal neurapraxia, and postthoracotomy pain [4,5,16,17]. Direct nerve stimulation in the lateral recess as well as along the nerve roots has also been described for PHN, post-thoracotomy pain, and ilioinguinal neurapraxia.…”

“…Given that many pain syndromes targeted in neuromodulation such as FBSS are often mixed pain syndromes, a treatment modality able to potentially target nociceptive pain is advantageous. Treatment of cervical discogenic pain with PNfS as well as disorders not associated with neuropathic pain including abdominal pain further suggest that PNfS may be beneficial as a treatment option for pain of different etiologies [5,13]. The difficulties of SCS in the long-term treatment of axial back pain are well described and may be related to SCS having a limited ability to treat nociceptive pain as well as the inability of conventional arrays to consistently obtain evoked paresthesia in the trunk [14,15].…”

Repositioning of Supraorbital Nerve Stimulation Electrode Using Retrograde Needle Insertion: A Technical Note

“…Peripheral nerve stimulation using percutaneously inserted electrodes has become an accepted modality for a variety of indications, including occipital neuralgia (2–5), cervicogenic headaches (6–8), trigeminal neuropathic pain (10–12), cluster headaches (13), post‐herpetic neuralgia (9,14), and all kinds of peripheral neuropathic pain syndromes in the lumbar area (15), inguinal region (16), abdomen (17), neck (18), chest wall (19) and upper (20,21) and lower extremities (22,23). It is now a subject of investigation as treatment modality for migraines (24) and even fibromyalgia (25).…”

Subcutaneous Stimulation: How to Assess Optimal Implantation Depth

“…Indications are not well established because therapeutic modalities have sometimes been confusing (2,10–13). One of the greatest confounding points is the use of the terms for stimulating a peripheral nerve directly and the fibers of a nerve as interchangeable.…”