Combined Spinal Cord and Peripheral Nerve Field Stimulation for Persistent Post-Herniorrhaphy Pain

Lepski, Guilherme; Vahedi, Payman; Tatagiba, Marcos; Morgalla, Matthias

doi:10.1111/j.1525-1403.2012.00463.x

Cited by 30 publications

(22 citation statements)

References 24 publications

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“…PNFS has been described in a couple of case reports,58,59,67 smaller cases series,56,62,65 and some studies with higher case numbers 61,64,68. A retrospective multicentre study on 111 patients with chronic low back pain, FBSS, cervical pain, postherpetic neuralgia, tension headache, and some patients with trigeminal neuralgia or thoracic pain showed that the relatively best pain relief was obtained in patients with thoracic back pain, whereas the least pain relief was seen in patients with tension headache.…”

Section: Current Technological Developmentsmentioning

confidence: 99%

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Spinal cord stimulation for neuropathic pain: current perspectives

Wolter¹

2014

JPR

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Neuropathic pain constitutes a significant portion of chronic pain. Patients with neuropathic pain are usually more heavily burdened than patients with nociceptive pain. They suffer more often from insomnia, anxiety, and depression. Moreover, analgesic medication often has an insufficient effect on neuropathic pain. Spinal cord stimulation constitutes a therapy alternative that, to date, remains underused. In the last 10 to 15 years, it has undergone constant technical advancement. This review gives an overview of the present practice of spinal cord stimulation for chronic neuropathic pain and current developments such as high-frequency stimulation and peripheral nerve field stimulation.

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Section: Current Technological Developmentsmentioning

confidence: 99%

“…A so-called “hybrid simulation”, combining SCS and PFNS, has also been proposed for various pain syndromes 61,62,65,67,72–74…”

Section: Current Technological Developmentsmentioning

confidence: 99%

Spinal cord stimulation for neuropathic pain: current perspectives

Wolter¹

2014

JPR

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“…Spinal cord stimulation (SCS) can be an effective and reversible treatment option for chronic neuropathic pain, and some positive results have been seen using neurostimulation with groin pain . An early case series from Simpson reported that for six SCS patients with “idiopathic chronic focal pain (loin, groin, etc.…”

Section: Introductionmentioning

confidence: 99%

Spinal Cord Stimulation of the Dorsal Root Ganglion for Groin Pain—A Retrospective Review

et al. 2014

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Early findings suggest that neuromodulation of the DRG may be an effective treatment for chronic neuropathic pain conditions in the groin region. This technique offers a useful alternative for pain conditions that do not always respond optimally to traditional SCS therapy. Neuromodulation of the DRG provided excellent cross-dermatomal paresthesia coverage, even in cases with patients with discrete pain areas. The therapy can be specific, sustained, and independent of body position.

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“…Two other studies demonstrated that PNFS has also shown promise in alleviating chronic postoperative inguinal pain and may serve as a complement to SCS . In a case series of three patients who experienced medically refractive, persistent inguinal neuropathic pain after herniorrhaphy, Stinson et al demonstrated that the use of PNFS can provide long‐term 75–100% pain relief . Furthermore, the authors found that all the patients were tapered off their pain medications and discontinued their pain‐related medical visits .…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Cost Analysis of Chronic Pain After Hernia Repair: A Potential Alternative Approach With Neurostimulation

Elsamadicy

Ashraf

Ren

et al. 2019

Neuromodulation: Technology at the Neural Interface

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Objectives Chronic pain (CP) affects a significant number of patients following hernia repair, ranging from 11 to 54% in the literature. The aim of this study was to assess the prevalence, overall costs, and health care utilization associated with CP after hernia repair. Materials and Methods A retrospective longitudinal study was performed using the Truven MarketScan® data base to identify patients who develop chronic neuropathic posthernia repair pain from 2001 to 2012. Patients were grouped into CP and No Chronic Pain (No CP) cohorts. Patients were excluded if they 1) were under 18 years of age; 2) had a previous pain diagnosis; 3) had CP diagnosed <90 days after the index hernia repair; 4) had less than one year of follow‐up; or 5) had less than one‐year baseline record before hernia repair. Patients were grouped into the CP cohort if their CP diagnosis was made within the two years following index hernia repair. Total, outpatient, and pain prescription costs were collected in the period of five years prehernia to nine years posthernia repair. A longitudinal multivariate analysis was used to model the effects of chronic neuropathic posthernia repair pain on total inpatient/outpatient and pain prescription costs. Results We identified 76,173 patients who underwent hernia repair and met inclusion criteria (CP: n = 14,919, No CP: n = 61,254). There was a trend for increased total inpatient/outpatient and pain prescription costs one‐year posthernia repair, when compared to baseline costs for both cohorts. In both cohorts, total inpatient/outpatient costs remained elevated from baseline through nine years posthernia repair, with the CP cohort experiencing significantly higher cumulative median costs (CP: $51,334, No CP: $37,388). The CP diagnosis year was associated with a 1.75‐fold increase (p < 0.001) in total inpatient/outpatient costs and a 2.26‐fold increase (p < 0.001) in pain prescription costs versus all other years. In the longitudinal analysis, the CP cohort had a 1.14‐fold increase (p < 0.001) in total inpatient/outpatient costs and 2.00‐fold increase (p < 0.001) in pain prescription costs. Conclusions Our study demonstrates the prevalence of CP after hernia surgery to be nearly 20%, with significantly increased costs and healthcare resource utilization. While current treatment paradigms are effective for many, there remains a large number of patients that could benefit from an overall approach that includes nonopioid treatments, such as potentially incorporating neurostimulation, for CP that presents posthernia repair.

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Combined Spinal Cord and Peripheral Nerve Field Stimulation for Persistent Post-Herniorrhaphy Pain

Cited by 30 publications

References 24 publications

Spinal cord stimulation for neuropathic pain: current perspectives

Spinal cord stimulation for neuropathic pain: current perspectives

Spinal Cord Stimulation of the Dorsal Root Ganglion for Groin Pain—A Retrospective Review

Prevalence and Cost Analysis of Chronic Pain After Hernia Repair: A Potential Alternative Approach With Neurostimulation

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