Wireless Peripheral Nerve Stimulation for Treatment of Peripheral Neuralgias

Abd‐Elsayed, Alaa

doi:10.1111/ner.13131

Cited by 26 publications

(17 citation statements)

References 10 publications

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“…Abd-Elsayed demonstrated the successful utilization of a wireless PNS system in five patients with different types of neuralgias, including cluneal neuralgia. This report adds to the evidence that PNS can successfully be utilized for patients with LBP due to SCN [ 12 ].…”

Section: Discussionmentioning

confidence: 65%

Superior Cluneal Neuralgia Treated With Wireless Peripheral Nerve Stimulation

Chauhan¹,

Levy²,

DeChellis³

2022

Cureus

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Superior cluneal neuralgia (SCN) can often be misdiagnosed when evaluating a patient with low back pain (LBP). The pathomechanics of SCN can range from direct injury following surgeries or trauma to myofascial compression due to abnormal muscle tone or fibrosis. The authors present a case of SCN in a 65-year-old male that persisted for three years following a laminectomy complicated by retained hardware and subsequent fibrosis. The patient’s diagnosis was confirmed with a diagnostic nerve block with significant pain relief after initial misdiagnosis and unsuccessful interventions targeting other possible pain generators. He ultimately underwent a successful peripheral nerve stimulation (PNS) trial and implantation with significant long-term pain relief. This case report entails the need to consider SCN in the differential for low back pain and the successful utilization of PNS for treatment.

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Section: Discussionmentioning

confidence: 65%

Superior Cluneal Neuralgia Treated With Wireless Peripheral Nerve Stimulation

Chauhan¹,

Levy²,

DeChellis³

2022

Cureus

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“…This treatment allows for wireless nerve stimulation of the CN, eliminating the need for surgery. 70 Researchers were able to use peripheral nerve stimulation to provide satisfactory pain control to all individuals in the study. 70 Using this technique, researchers were able to lower the pain score from 6.4 before treatment, to 1 after treatment.…”

Section: Conservative Treatmentmentioning

confidence: 99%

“…70 Researchers were able to use peripheral nerve stimulation to provide satisfactory pain control to all individuals in the study. 70 Using this technique, researchers were able to lower the pain score from 6.4 before treatment, to 1 after treatment. 70 Although peripheral nerve stimulation, using this technique, has been shown to significantly reduce the pain caused by CN, it is likely to not be used as the initial, non-surgical treatment.…”

Section: Conservative Treatmentmentioning

confidence: 99%

“…70 Using this technique, researchers were able to lower the pain score from 6.4 before treatment, to 1 after treatment. 70 Although peripheral nerve stimulation, using this technique, has been shown to significantly reduce the pain caused by CN, it is likely to not be used as the initial, non-surgical treatment. It is most useful in individuals whose pain is resistant to other non-surgical medical treatments.…”

Section: Conservative Treatmentmentioning

confidence: 99%

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A Comprehensive Review of Cluneal Neuralgia as a Cause of Lower Back Pain

et al. 2022

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Lower back pain (LBP) is one of the most common presenting complaints in clinical adult medical patients. While most often diagnosed as “nonspecific mechanical” in etiology, several lesser known, rarer causes of LBP exist, some of which can even cause neuropathic pain. One of these infrequent causes, cluneal neuralgia (CN), is associated most often with damage or entrapment of the cluneal nerves, particularly the superior cluneal nerve (SCN) and/or the middle cluneal nerve (MCN). These nerves supply sensation to the posterior lumbar and buttock area. However, the LBP caused by CN is often difficult to recognize because it can mimic radiculopathy or sacroiliac joint (SIJ) pain or lead to symptoms in the legs. This makes CN significantly important for clinicians and surgeons to include in their differential. A thorough history proves beneficial in the diagnostic workup, as many risk factors for CN have been reported in the literature. If a CN diagnosis is made, several effective conservative measures can alleviate patients’ pain, such as nerve blocks, peripheral nerve stimulation, or high frequency thermal coagulation. Additionally, surgical treatments, such as CN release or endoscopic decompression, have resulted in fantastic patient outcomes. The purpose of the present investigation is to investigate the existing literature about CN as a cause for LBP, consider its epidemiology, discuss its pathophysiology and risk factors, elucidate its clinical presentation and diagnosis, and examine the various treatment modalities that have been reported across the world.

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“…Neuromodulation has been shown to be an effective nonsurgical option for the management of chronic pain 1,2 . Spinal cord stimulators have become popularized to treat back pain refractory to medications and therapy while peripheral nerve stimulators for the superior cluneal, sural, ilioinguinal, and genitofemoral nerves have recently gained traction as well 3,4 . Possible complications of peripheral nerve stimulator implantation include lead migration, lead fracture, device-related pain, infection, and neurological injury 5 .…”

mentioning

confidence: 99%

Superior Cluneal Nerve Stimulator Lead Displacement to the Thigh

Song

Humphrey

Zhang

et al. 2022

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Case: An 82-year-old man with a history of lumbar spinal stenosis and prior laminectomy presented with chronic lower back pain and was treated with placement of bilateral superior cluneal nerve stimulators. At the 2-week follow-up, the patient reported loss of efficacy and new-onset paresthesia of the left lower extremity. Fluoroscopic evaluation revealed lead breakage and distal migration of the left-sided stimulator lead to the left anteromedial thigh. Conclusion:Lead breakage and migration remains a challenge in peripheral nerve stimulation. This report illustrates the case of a nerve stimulator lead breakage and migration resulting in treatment failure and new-onset sensory disturbance.Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/B881).

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Wireless Peripheral Nerve Stimulation for Treatment of Peripheral Neuralgias

Cited by 26 publications

References 10 publications

Superior Cluneal Neuralgia Treated With Wireless Peripheral Nerve Stimulation

Superior Cluneal Neuralgia Treated With Wireless Peripheral Nerve Stimulation

A Comprehensive Review of Cluneal Neuralgia as a Cause of Lower Back Pain

Superior Cluneal Nerve Stimulator Lead Displacement to the Thigh

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