Session Information
Date: Thursday, November 14, 2019
Session Title: Spine and Pain Case Report
Session Time: 12:30pm-2:00pm
Location: Research Hub - Kiosk 7
Disclosures: Stephen K. Anderson, MD: Nothing to disclose
Case Description: Spinal cord stimulation (SCS) in a complicated case of chronic neuropathic pain after spinal cord injury.
Setting: Outpatient pain management center.
Patient: A 53-year-old ambulatory male with history of incomplete cervical spinal cord injury in 2008 with cervical fusion and subsequent C5-C7 decompression, chronic neuropathic pain, and prior high dose opioid use.
Assessment/Results: A 53-year-old male presented to pain clinic for further evaluation of chronic neuropathic pain in setting of spinal cord injury, with the majority of his pain being located in his feet and thighs, with additional pain in his left abdomen. He was evaluated by neuropsychology and was educated on the benefits and limitations of SCS for pain relief. He was cleared for SCS and underwent successful SCS trial with >80% pain relief. He subsequently underwent permanent implantation of SCS 1 month later under fluoroscopic guidance. SCS leads were successfully placed at the midbody of T10-T12 to cover his painful areas. He tolerated the procedure well, and on follow-up visit he reported 85% relief of neuropathic pain symptoms in his lower limbs. Patient also reported increased activity level including improved quality of life, ambulation and even improvement in his mood.
Discussion: Although there is limited evidence for the use of SCS in the treatment of neuropathic pain in spinal cord injured patients, our patient did very well and had significant relief of pain. During this process, it was important to set clear expectations regarding potential benefits and limitations of this therapy. Neuropsychological testing was utilized as an assistive tool rather than merely for procedural clearance with plan for ongoing follow up and management.
Conclusion: Spinal cord stimulation may provide significant relief of chronic neuropathic pain in patients with spinal cord injuries, however, additional and longitudinal studies in this population are needed.
Level of Evidence: Level V
To cite this abstract in AMA style:
Anderson SK, Thakkar N, Vallabh J. Spinal Cord Stimulation (SCS) in a Complicated Case of Chronic Neuropathic Pain After Spinal Cord Injury [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/spinal-cord-stimulation-scs-in-a-complicated-case-of-chronic-neuropathic-pain-after-spinal-cord-injury/. Accessed May 12, 2025.« Back to AAPM&R Annual Assembly 2019
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/spinal-cord-stimulation-scs-in-a-complicated-case-of-chronic-neuropathic-pain-after-spinal-cord-injury/