Faculty Collaboration Database

Complete coverage of phantom limb and stump pain with constant current SCS system: a case report and review of the literature. Pain Pract 2015 Jan;15(1):E20-6

Date

06/13/2014

Pubmed ID

24919840

DOI

10.1111/papr.12226

Scopus ID

2-s2.0-84921868710 (requires institutional sign-in at Scopus site)   9 Citations

Abstract

BACKGROUND: Spinal cord stimulator (SCS) technology has advanced over the past several years. However, our literature review revealed a lack of well-documented cases of successful treatment of phantom limb pain with percutaneous revision of previously placed systems.

CASE REPORT: We present the case of a patient who suffered from debilitating bilateral lower extremity phantom limb pain despite having a SCS with a constant voltage system. We used fluoroscopy to successfully guide a percutaneous octapolar paddle lead to the right of the existing surgical paddle lead and a cylindrical quadrapolar lead in between. Finally, the older paddle lead was connected to an extension to make it compatible with the updated constant current system. The revised constant current SCS system provided bilateral coverage of the patient's pain, and at 1-year postoperative, the patient reported he had sustained coverage from his bilateral phantom limb pain. Our patient had complete coverage of his phantom limb pain after his previously placed SCS was changed from a constant voltage to a constant current system, and percutaneous leads were connected to his system. Adding percutaneous leads or switching generator types may benefit patients whose pain patterns have expanded since original SCS system placement. This case reports the complete coverage of phantom limb pain with a change from a constant voltage to a constant current SCS system and the addition of percutaneous leads to an existing SCS system.

Author List

Bunch JR, Goldstein HV, Hurley RW

Author

Robert W. Hurley MD, PhD Adjunct Professor of Anesthesiology and CTSI in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Humans
Male
Middle Aged
Pain Management
Pain Measurement
Phantom Limb
Spinal Cord Stimulation