Use of Spinal Cord Stimulation in the Treatment of Phantom Limb Pain: Case Series and Review of the Literature
Article first published online: 19 APR 2010
© 2010 World Institute of Pain
Volume 10, Issue 5, pages 479–484, September/October 2010
How to Cite
Viswanathan, A., Phan, P. C. and Burton, A. W. (2010), Use of Spinal Cord Stimulation in the Treatment of Phantom Limb Pain: Case Series and Review of the Literature. Pain Practice, 10: 479–484. doi: 10.1111/j.1533-2500.2010.00374.x
- Issue published online: 30 AUG 2010
- Article first published online: 19 APR 2010
- Submitted: November 15, 2009; Revision accepted: February 4, 2010
- deafferentation pain
Introduction: Despite technical advances in spinal cord stimulation (SCS), there is a paucity of recent literature regarding SCS for phantom limb pain.
Methods: Between 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.
Results: Postoperatively, all patients subjectively reported excellent pain relief (>80%). Patients were all followed with the Brief Pain Inventory. Patients 1 to 3 each reported a two-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.
Conclusions: For selected patients who have not obtained adequate relief with medical management, SCS for phantom limb pain can prove an effective intervention. ▪