Some cases of thoracic back pains can get horrendous – partially because there are pain generators coming form both thoracic spine and neck, and because postural and instability effects are rampant there as well. It seems that measures may only had temporary effects. Now a case of peripheral field generation helped – but included both a low cervical and a thoracic leads – susceptible to migration…
IASP Poster Presentation Number: PW 362, Montreal 2010
PERIPHERAL NERVE FIELD STIMULATION IN A CASE CHRONIC THORACIC PAIN
D. L. Sommerfield1, P. Hu1, D. O’Keeffe2, C. Power1, 1Dept of Pain Med., Adelaide & Meath Hopsital, Tallaght, Dublin 24, Ireland, 2Dept of Pain Med., St. Vincents Univ. Hosp., Dublin 4, Ireland
- 46 year old female patient, with a history of childhood poliomyelitis
- electroacupuncture produced short term benefit
- 4 octrodes (8 contact electrodes; Advanced Bionics), 2 implantable pulse generators.
- “positioned on either side of the midline vertically along the thoracic paraspinous muscles”
- at C6 and T10 – 3 cm from midline – 60 hertz alternating
Anchoring was the major technical feat and required major measures:
- Histoacryl glue and “strain relieving loop all secured with 2-0 Ethibond sutures”
- 2 anchors/lead – one anchor 20 cm distally
- “additional suture placed directly onto the lead as part of the strain loop”
- “Each lead was then connected to an extension (25 cm SC-3138) and tunnelled to the ipsilateral IPG site.”
- deep paraspinous muscle bites
36 months – 60% better
Comment – needed positive response to “electroacupuncture” – more like needle stim to area I suspect; also going to need a surgeon with skill and patience – though you are only subcutaeous.