Yale University School of Medicine, West Haven, CT, USA.
Pain Physician. 2012 Jul-Aug;15(4):303-9.
To report a case of Raynaud disease and its successful treatment with spinal cord stimulation utilizing the newly designed five-column Penta lead paddle. Specific electrode design, programming characteristics, and surgical technique are also discussed in this case.
Case Report.
University pain management center.
A 65-year-old man with Raynaud disease presented with neck and upper extremity pain. The patient also had herniation and spondylosis of the lumbar spine and intervertebral disc disease of the cervical spine. An examination revealed venous changes, chronic ulceration, and digit discoloration in upper and lower extremities.
Conservative management and pharmacological treatment were ineffective. Sympathetic block produced significant but limited improvement. Treatment with spinal cord stimulation was tried after a successful 7-day trial.
Initial stimulation of the cervical spine with two octapolar leads at the C2 level produced greater than 75% pain improvement. However, the patient lost coverage shortly after discharge due to lead migration which could not be regained with reprogramming. A revision with Penta lead paddles produced sustainable and significant paresthesia coverage.
A case report.
We report the successful application of spinal cord stimulation utilizing a five-column paddle lead in an individual with severe refractory Raynaud disease.
报告一例雷纳德病，采用新设计的五柱桨形 Penta 导联成功治疗。本病例还讨论了特定的电极设计、编程特点和手术技术。
病例报告。
大学疼痛管理中心。
一名 65 岁男性，患有雷纳德病，伴有颈部和上肢疼痛。该患者还患有腰椎间盘突出症和颈椎椎间盘疾病。检查发现上肢和下肢静脉变化、慢性溃疡和指端变色。
保守治疗和药物治疗无效。交感神经阻滞产生了显著但有限的改善。在成功进行了 7 天的试验后，尝试了脊髓刺激治疗。
在 C2 水平用两个八极导联对颈椎进行初始刺激，疼痛改善超过 75%。然而，患者在出院后不久因导联移位而失去覆盖范围，重新编程无法恢复。使用 Penta 导联桨进行修订产生了可持续和显著的感觉异常覆盖。
病例报告。
我们报告了一例严重难治性雷纳德病患者成功应用脊髓刺激，采用五柱桨形导联。
