Billet Bart, Wynendaele Roel, Vanquathem Niek E
AZ Delta Hospital, Roeselare, Belgium.
StimRelieve LLC, Pompano Beach, Florida, U.S.A.
Pain Pract. 2018 Mar;18(3):374-379. doi: 10.1111/papr.12607. Epub 2017 Nov 20.
BACKGROUND: Peripheral nerve stimulation of primary afferent neurons provides control of localized chronic pain. This technique applies permanent electrical stimulation at the target area via a minimally invasive, subcutaneous placement of an electrode. OBJECTIVE: To assess the analgesic effects of minimally invasive wireless neuromodulation in the treatment of chronic intractable pain secondary to post-herpetic neuralgia. CASE SUMMARY: A 78-year-old man presented with severe intractable post-herpetic neuralgic pain. He was known to have non-Hodgkin's lymphoma under remission following treatment with chemotherapy and stem cell transplantation, twice. He also developed steroid-induced diabetes mellitus during this treatment. In view of his compromised immune status, he was deemed a suitable candidate for our minimally invasive neuromodulation technology. Two subcutaneous electrodes were placed on the right-hand side of the trunk, 10 cm medial and parallel to the spinous process at the level of T7-T8 under fluoroscopic guidance along the T7 intercostal nerve. The external transmitter was worn with a belt over a single layer of clothing and used to transmit power to the stimulator. The entire procedure required only a small incision for the introduction of the electrode placement. RESULTS: After an uneventful procedure, the pain score decreased from 8 to 3, with a reduction in pain medication. The EuroQol Five Dimensions Questionnaire scores were 0.102 before the trial, 0.630 at 1 month, and 0.576 at 3 months. CONCLUSIONS: Subcutaneous placement of electrodes with our minimally invasive technique and wireless neuromodulation technology was safe and effective. Significant improvements in pain relief ensued, and no further adverse events had been reported at the end of 3 months' follow-up.
背景:对初级传入神经元进行外周神经刺激可控制局部慢性疼痛。该技术通过微创皮下放置电极在目标区域施加永久性电刺激。 目的:评估微创无线神经调节治疗带状疱疹后神经痛继发的慢性顽固性疼痛的镇痛效果。 病例摘要:一名78岁男性,患有严重的顽固性带状疱疹后神经痛。他曾接受过两次化疗和干细胞移植治疗,目前处于缓解期的非霍奇金淋巴瘤。在此治疗期间,他还患上了类固醇诱导的糖尿病。鉴于其免疫功能受损,他被认为是我们微创神经调节技术的合适候选者。在透视引导下,沿着T7肋间神经,在T7 - T8水平棘突内侧10 cm处且与之平行的躯干右侧放置两个皮下电极。外部发射器通过腰带佩戴在单层衣物上,用于向刺激器传输能量。整个过程仅需一个小切口用于电极置入。 结果:手术顺利完成后,疼痛评分从8分降至3分,止痛药物用量减少。欧洲五维健康量表评分在试验前为0.102,1个月时为0.630,3个月时为0.576。 结论:采用我们的微创技术和无线神经调节技术进行皮下电极置入是安全有效的。疼痛缓解有显著改善,在3个月随访结束时未报告进一步的不良事件。
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