Successful Treatment of Pudendal Neuralgia With Tricolumn Spinal Cord Stimulation: Case Report

被引：15

作者：

Rigoard, Philippe ^{[1
,6
]}

Delmotte, Alexandre ^{[1
]}

Moles, Alexis ^{[1
]}

Hervochon, Remi ^{[1
]}

Vrignaud, Thomas ^{[1
]}

Misbert, Lorraine ^{[2
]}

Lafay, Nicolas ^{[2
,3
]}

D'Houtaud, Samuel ^{[1
]}

Frasca, Denis ^{[4
]}

Guenot, Claude ^{[4
]}

Giot, Jean-Philippe ^{[5
]}

Diallo, Bakari ^{[2
]}

Bataille, Benoit ^{[1
]}

机构：

[1] Univ Poitiers, Sch Med, Dept Neurosurg, Poitiers, France

[2] Univ Poitiers, Sch Med, Pain Management & Res Ctr, Poitiers, France

[3] Univ Poitiers, Sch Med, Dept Psychiat, Poitiers, France

[4] Univ Poitiers, Sch Med, Dept Anesthesiol, Poitiers, France

[5] Univ Poitiers, Sch Med, Dept Morphol, Poitiers, France

[6] Univ Poitiers, INSERM, CIC 802, Poitiers, France

来源：

NEUROSURGERY | 2012年 / 71卷 / 03期

关键词：

Conus medullaris anatomy; Multicolumn spinal cord stimulation; Perineal pain relief; Programming; Quality of life; Refractory pudendal neuralgia; SYMPTOMATIC APPROACH; PAIN SYNDROME; FOLLOW-UP; TRIAL;

D O I：

10.1227/NEU.0b013e318260fd8f

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

BACKGROUND AND IMPORTANCE: There is large variation in the success of decompressive surgery for pudendal neuralgia (PN), the most chronic, disabling form of perineal pain. We attempt to determine whether spinal cord stimulation using new-generation multicolumn leads could form part of the treatment algorithm for refractory PN. CLINICAL PRESENTATION: A man with PN that was unresponsive to conventional treatment demonstrated a neuropathic component and had a negative response to nerve infiltrations (so he was not indicated for decompressive surgery) and a positive response to perianal transcutaneous electrical nerve stimulation and was implanted with a 16-contact surgical lead at the level of conus medullaris, allowing multicolumn stimulation. Using transverse combinations, it was possible to obtain 100% paresthesia over the perineal area without unwanted dorsal root stimulation. Perineal and radicular pain was successfully relieved for up to 12 months (80% and 60% reduction in the visual analogue scale scores, respectively), with an improvement in all quality of life domains and a reduction in drug consumption. CONCLUSION: Spinal cord stimulation using a 16-contact lead may be a viable therapeutic option for patients with refractory PN for whom decompressive surgery is contraindicated.

引用

页码：E757 / E762

页数：6

共 14 条

[1] Pudendal neuralgia, a severe pain syndrome [J].