Spinal cord stimulation for the treatment of chronic renal pain secondary to uretero-pelvic junction obstruction.

BACKGROUND Chronic renal pain secondary to uretero-pelvic junction obstruction (UPJO) is common but remains poorly understood. Patients with UPJO experience frequent infections, renal calculi and pain. Management options for patients with this condition are traditionally limited to surgical interventions to eliminate the obstruction. Spinal Cord Stimulation (SCS) has gained widespread popularity for the treatment of numerous conditions from complex regional pain syndrome to failed back syndrome. With continued success, the possible use of SCS has steadily increased. Although a significant number of patients with severe chronic renal pain will transiently respond to analgesics and physical interventions such as autonomic sympathetic blocks, substantial long-term pain relief is usually lacking. SCS therefore might be a welcome addition to the treatment of moderate to severe chronic renal pain. OBJECTIVE This article presents a case of using spinal cord stimulation in the management of chronic renal pain secondary to uretero-pelvic junction obstruction. DESIGN Case report. SETTING Academic University Pain Management Center METHODS A 38-year old female presented with a 15-year history of persistent right sided flank pain secondary to congenital uretero-pelvic junction obstruction. After failing to respond adequately to stenting, medications and nerve blocks, a trial of spinal cord stimulation and subsequent permanent implantation of a spinal cord stimulator (SCS) were performed. RESULTS The patient reported significant improvement in pain, overall functioning and no consumption of opioids during the SCS trial and following system implant. LIMITATIONS A case report. CONCLUSION Spinal cord stimulation might be an option in the management of chronic renal pain secondary to uretero-pelvic junction obstruction.