A case report of effective cervicothoracic spinal cord stimulation for lower limbs and trunk pain

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  • Ishiuchi Takamasa
    Department of Neurosurgery, Osaka University Graduate School of Medicine
  • Hosomi Koichi
    Department of Neurosurgery, Osaka University Graduate School of Medicine
  • Mori Nobuhiko
    Department of Neurosurgery, Osaka University Graduate School of Medicine
  • Nishi Asaya
    Department of Neurosurgery, Osaka University Graduate School of Medicine
  • Matsuhashi Takahiro
    Department of Neurosurgery, Osaka University Graduate School of Medicine
  • Kimoto Yuki
    Department of Neurosurgery, Osaka University Graduate School of Medicine
  • Iwata Takamitsu
    Department of Neurosurgery, Osaka University Graduate School of Medicine
  • Onoda Yuji
    Department of Neurosurgery, Osaka University Graduate School of Medicine
  • Emura Takuto
    Department of Neurosurgery, Osaka University Graduate School of Medicine
  • Miura Shinpei
    Department of Neurosurgery, Osaka University Graduate School of Medicine
  • Fujita Yuya
    Department of Neurosurgery, Osaka University Graduate School of Medicine
  • Khoo Hui Ming
    Department of Neurosurgery, Osaka University Graduate School of Medicine
  • Yanagisawa Takufumi
    Department of Neurosurgery, Osaka University Graduate School of Medicine Institute for Advanced Co–creation Studies, Osaka University
  • Tani Naoki
    Department of Neurosurgery, Osaka University Graduate School of Medicine
  • Oshino Satoru
    Department of Neurosurgery, Osaka University Graduate School of Medicine
  • Kishima Haruhiko
    Department of Neurosurgery, Osaka University Graduate School of Medicine

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Other Title
  • 頚胸椎移行部の脊髄刺激で両下肢体幹部の除痛が得られた１例

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Description

<p>We experienced a case in which stimulating the central side of the lesion successfully induced an extensive paresthesia at and below the spinal lesion, despite the severe sensory impairment in the same area. A woman in her 50s had a spinal tumor at T5–8 that was removed about 30 years ago. She had residual pain in both her lower extremities and the right side of the chest accompanied by a severe sensory disturbance below the T5 level, which were resistant to medication. She finally opted for an SCS to treat her neuropathic pain. During the stimulation trial, we placed a percutaneous cylindrical lead at the midline in the epidural space at C7–T2 through a puncture at T2–3. Tonic stimulation at T1–2 induced paresthesia at both sides in the axilla, trunk, and lower extremities, which has led to an improvement in the pain score from 10 to 7 (numerical rating scale; NRS). During the definitive implantation, we placed two cylindrical leads at the midline at C6–T2. With the same parameters as the trial stimulation, her pain score improved to 5 in NRS, which has led to an overall improvement of her quality of life, psychological conditions, and activity of daily living. Despite the severely damaged spinal sensory pathways and the broadly distributed pain area, it was possible to induce paresthesia and to achieve pain relief by stimulating the midline of the dorsal spinal cord and intact sensory pathways above the level of the spinal lesion.</p>

Journal

  • PAIN RESEARCH

    PAIN RESEARCH 37 (2), 68-74, 2022-07-15

    JAPANESE ASSOCIATION FOR STUDY OF PAIN

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