Presented at the 2012 AAPM Annual Meeting « Back

Spinal Cord and Peripheral Nerve Field Stimulation for Cervical Postlaminectomy Syndrome

Alexander E. Yakovlev, MD, aeyakovlev@yahoo.com¹, Beth E. Resch, APNP¹, (1) Comprehensive Pain Management of the Fox Valley SC, Appleton, Wisconsin

Background and Aims: Patients with cervical postlaminectomy syndrome (PLS) may continue to experience neck pain despite conventional treatments and minimally invasive procedures like spinal cord stimulation (SCS), which is more successful for covering arm pain. Control of neck pain is difficult to achieve during SCS trial or to maintain after placement of SCS. We report successful treatment of chronic neck and arm patient with cervical PLS with spinal cord and peripheral nerve field stimulation (PNFS). Methods: A 48-year-old female with a 6-year history of neck and bilateral arm pain related to PLS had minimal relief with conservative medication management, trigger point injections, and epidural injections. SCS implant relieved arm pain, but not neck pain. She underwent successful trial of two 8-electrode leads (Medtronic Inc., Minneapolis, MN) subcutaneously placed in paraspinal areas of cervical spine . During PNFS trial, patient reported greater than 80% improvement in pain and 2 weeks later underwent placement of permanent leads and RestoreULTRA rechargeable generator. Results: After final implantation, the patient reported significant pain relief (80% reduction in VAS) at 12 months and used stimulator 24 hours per day. She discontinued opioid and non-opioid pain medications and was able to resume occupational duties. Conclusion: SCS and PNFS is a treatment option for patients with neck and arm pain related to PLS in patients who have exhausted conservative therapies and interventional pain techniques. Neuromodulation techniques including SCS and PNFS can result in adequate pain control and lead to functional recovery.

Funding: None