Session Time: 11:15am-12:45pm
Location: Research Hub - Kiosk 6
Disclosures: Collin Grant, MD: Nothing to disclose
Case Description: A 47-year-old female with history of breast cancer presented to outpatient clinic with chronic bilateral leg pain secondary to chemotherapy-induced peripheral neuropathy. A multimodal approach to her pain including physical therapy, cognitive behavioral therapies, and medication management provided minimal benefit. She was in the process of being evaluated for a spinal cord stimulator (SCS) when she developed right sided chest wall ostealgia from new metastasis. Two spinal cord stimulator leads were placed with 0 electrode at top of T9 vertebral body and top of T10 respectively. The SCS was then calibrated to the patient’s pain complaints.
Setting: Outpatient clinic
Patient: A 47-year-old female
Assessment/Results: Pre-operative pain score was 7 out of 10 and post-operatively reduced to 3 out of 10. With further use and re-programming, she experienced pain relief of 90 percent in both her lower limbs as well as her right chest wall ostealgia. A permanent spinal cord stimulator was placed. Upon follow up, she had near complete resolution of her lower limb and rib pain.
Discussion: Ostealgia secondary to metastases and chemotherapy/radiation-induced peripheral neuropathy are common pain complaints associated with cancer. These conditions have different etiologies along with separate pathophysiology; however, they can both be refractory to conventional treatment strategies. While having separate etiologies they are being increasingly seen in the cancer patient population. SCS offers the potential of covering both pain sources with one modality.
Conclusion: Dorsal column stimulation shows promise in offering coverage of both metastatic ostealgia as well as peripheral neuropathy which is frequently seen in the cancer patient population.
Level of Evidence: Level V
To cite this abstract in AMA style:Grant C, Luke WR, Thompson R, Scribner D. Dual Coverage of Metastatic Ostealgia and Cancer-related Peripheral Neuropathy with a Spinal Cord Stimulator [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/dual-coverage-of-metastatic-ostealgia-and-cancer-related-peripheral-neuropathy-with-a-spinal-cord-stimulator/. Accessed December 9, 2023.
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