• J Hand Surg Am · Mar 2021

    Case Reports

    Ultrasound-Guided Percutaneous Peripheral Nerve Stimulation for the Treatment of Chronic Intractable Pain Originating From a Lipofibromatous Hamartoma of the Median Nerve.

    • Guilherme Ferreira-Dos-Santos, HurdleMark Friedrich BMFBDepartment of Pain Medicine, Mayo Clinic, Jacksonville, FL., Sahil Gupta, Salim M Ghazi, Stephen D Trigg, and Steven R Clendenen.
    • Department of Physical Medicine and Rehabilitation, Central Lisbon University Hospital Center, Lisbon, Portugal; NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal. Electronic address: guilhermesantos@campus.ul.pt.
    • J Hand Surg Am. 2021 Mar 1; 46 (3): 250.e1-250.e5.

    AbstractThis case report presents an application of peripheral nerve stimulation to the median nerve to treat a patient with intractable pain due to a lipofibromatous hamartoma of the left upper extremity. Ultra high-frequency ultrasound was used to determine the boundaries of the hamartoma. The patient then underwent an ultrasound-guided implantation of 2 stimulator electrodes distal to the elbow along the median nerve with stimulation coverage achieved at 1.2 and 1.4 mA, respectively. After an uneventful procedure, the pain score immediately decreased from 9 out of 10 to less than 6 on a numeric rating scale. Two weeks after the procedure, the patient reported substantial pain relief, with an average pain level of 5 to 6 out of 10. Twelve months after implantation, the patient maintained significant pain relief, rating her average pain level as a 4 to 6 out of 10. Placement of a percutaneous peripheral nerve stimulator was safe and effective with no adverse events being reported at the 12-month follow-up.Copyright © 2021 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

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