• Eugene Kim, Sean Gamble, Adina Schwartz, and Giovanni Cucchiaro.
• Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA.
• Clin J Pain. 2018 Nov 1; 34 (11): 983-990.

ObjectivesNeuromodulation, particularly intrathecal drug delivery systems and spinal cord stimulators (SCSs), can be a valuable tool when treating chronic pain in adults. However, there is a paucity of literature with regard to its use in pediatrics.Materials And MethodsWe present a series of 14 children and adolescents with intractable pain who received a SCS or a pump for the intrathecal delivery of medications between 2010 and 2016 at our institution.ResultsDuring the study period, we placed 10 intrathecal pumps and 4 SCSs with an average age of 17 years old. Pain scores significantly improved after the implant (P<0.007) and function improved in 79% of patients. Opioid use was also significantly reduced. Three patients eventually had their device removed due to psychiatric comorbidities. Four patients had complications that were treated without further sequelae.ConclusionsNeuromodulation can offer important options in treating some pediatric chronic pain patients. In-depth knowledge of primary disease and strict patient selection in the context of the patient's social situation is vital to successful treatment.

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