Berger Amnon A, Hasoon Jamal, Urits Ivan, Viswanath Omar, Gill Jatinder
Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Anesthesia, Critical Care and Pain Medicine, Boston, MA, USA.
Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ, USA.
J Pain Res. 2020 Apr 30;13:873-875. doi: 10.2147/JPR.S244084. eCollection 2020.
Chronic pain affects roughly 50 million Americans, or 20.4% of the national population, and is a huge economic burden on society. Spinal cord stimulation (SCS) is a cost-effective interventional treatment modality for patients with chronic neuropathic and radicular pain. It is traditionally reserved for patients suffering from post-laminectomy syndrome, complex regional pain syndrome, or chronic back pain that is refractory to other less invasive techniques. There have been a few cases describing the use of SCS at higher levels to successfully obtain coverage of visceral abdominal pain. Here we describe an interesting case of a patient who suffered from chronic back pain and radiculopathy with post-laminectomy syndrome as well as chronic abdominal pain. We describe the use of high-frequency SCS to alleviate the patient's post-laminectomy pain as well as his abdominal pain. Our case describes SCS use with multi-level lead placement targeting both post-laminectomy pain and abdominal pain. We describe a strategy that can be useful to patients with concurrent pain from more than one source. Our case also adds to the growing evidence supporting the use of SCS for treating chronic visceral pain syndromes.
慢性疼痛影响着大约5000万美国人，占全国人口的20.4%，给社会带来了巨大的经济负担。脊髓刺激（SCS）是一种具有成本效益的介入治疗方式，适用于慢性神经性和根性疼痛患者。传统上，它只用于患有椎板切除术后综合征、复杂性区域疼痛综合征或对其他侵入性较小的技术无效的慢性背痛患者。已有少数病例描述了在更高水平使用SCS成功覆盖内脏腹痛的情况。在此，我们描述了一例有趣的病例，该患者患有慢性背痛、神经根病伴椎板切除术后综合征以及慢性腹痛。我们描述了使用高频SCS缓解患者的椎板切除术后疼痛以及腹痛的情况。我们的病例描述了通过多节段导联放置使用SCS来治疗椎板切除术后疼痛和腹痛。我们描述了一种对同时患有多种疼痛的患者可能有用的策略。我们的病例也进一步证明了支持使用SCS治疗慢性内脏疼痛综合征的证据越来越多。
