Ultrasound-guided percutaneous peripheral nerve stimulation for chronic refractory neuropathic pain: a unique series

• Published in: Pain management Vol. 13; no. 1; pp. 15 - 24
• Main Authors: Ferreira-Silva, Nuno, Ferreira-Dos-Santos, Guilherme, Gupta, Sahil, Hunt, Christine L, Eldrige, Jason S, Pingree, Matthew J, Clendenen, Steven R, Hurdle, Mark Friedrich B
• Format: Journal Article
• Language: English
• Published: England Future Medicine Ltd 01.01.2023
• Subjects: case series; Electric Stimulation Therapy - methods; Humans; implantable neurostimulators; intractable pain; neuralgia; Neuralgia - diagnostic imaging; Neuralgia - therapy; pain management; peripheral nerve injuries; peripheral nerves; Peripheral Nerves - diagnostic imaging; Transcutaneous Electric Nerve Stimulation - methods; ultrasonography; Ultrasonography, Interventional - methods; intractable pain; case series; ultrasonography; peripheral nerve injuries; peripheral nerves; neuralgia; pain management; implantable neurostimulators
• ISSN: 1758-1869; 1758-1877
• DOI: 10.2217/pmt-2022-0070

During the last two decades, with the advent of recent technology, peripheral nerve stimulation has become an appealing modality at the forefront of pain management. In this case series, we document the clinical rationale and technical considerations on three of the most challenging cases, refractory to previous interventions, that were treated by our team with an ultrasound-guided percutaneous peripheral nerve stimulator targeting the musculocutaneous, bilateral greater occipital and subcostal nerves. At the 6-month follow-up, all patients experienced greater than 50% relief of baseline pain, with a near-complete resolution of pain exacerbations. Furthermore, to our knowledge, this is the first report of an ultrasound-guided percutaneous technique of a peripheral nerve stimulator targeting the musculocutaneous and subcostal nerves. Peripheral nerve stimulation is a new tool used in the treatment of peripheral nerve pain. In this study, we share our experience using this technology in three unusual, difficult-to-treat chronic nerve pain presentations, targeting the musculocutaneous, bilateral greater occipital and subcostal nerves. All patients were asked about how pain levels had changed since the peripheral nerve stimulation device had been implanted. In every case, patients reported a decline in their pain level from day one. After 6 months of peripheral nerve stimulator use, all patients reported a greater than 50% pain relief.