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Review Case Reports
Use of spinal cord stimulation in the treatment of phantom limb pain: case series and review of the literature.
- Ashwin Viswanathan, Phillip Cuong Phan, and Allen Wade Burton.
- M.D. Anderson Cancer Center, Neurosurgery, Houston, Texas, USA.
- Pain Pract. 2010 Sep 1;10(5):479-84.
IntroductionDespite technical advances in spinal cord stimulation (SCS), there is a paucity of recent literature regarding SCS for phantom limb pain.MethodsBetween January 2003 and May 2008, four patients at M.D. Anderson Cancer Center underwent SCS for intractable phantom limb pain. A retrospective chart review was performed to assess outcomes and complications. A PubMed search was performed to review previously published series regarding the efficacy of SCS for phantom limb pain.ResultsPostoperatively, all patients subjectively reported excellent pain relief (>80%). Patients were all followed with the Brief Pain Inventory. Patients 1 to 3 each reported at wo-point decrease in their usual amount of pain using the numerical rating scale. Patient 4's numerical pain scale was unchanged. When using an 11-point scale to assess other symptomology along 10 dimensions, patients 1 to 3 demonstrated a decrease in their total symptom score by 13, 14, and 4 points, respectively. Patient 4 reported an increase by 5 points in his total symptom score. With regard to complications, patient 2 developed an allergic dermatitis to the generator requiring revision with a polyfluoroethylene (GorTex) pouch. Patient 3 developed a surgical site infection after an implantable pulse generator change. Patients 2 to 4 were very satisfied with their stimulator and would choose to undergo implantation again, with patient 1 having an equivocal response.ConclusionsFor selected patients who have not obtained adequate relief with medical management, SCS for phantom limb pain can prove an effective intervention.
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