Treatment of intractable hip pain after THA and GTB using peripheral nerve field stimulation: a case series.

نویسندگان

  • Alexander E Yakovlev
  • Beth E Resch
  • Sergey A Karasev
چکیده

OBJECTIVE It has been estimated that 10%-35% of patients who undergo total hip arthroplasty (THA) have chronic postoperative pain, most often located at the greater trochanter. After greater trochanteric bursectomy (GTB), patients also may continue to experience chronic surgical site pain. Chronic pain has a neuropathic component, which often responds poorly to opioids. In an attempt to provide increased pain relief for patients with intractable chronic pain, unconventional agents and interventional management approaches have received considerable attention. Peripheral nerve field stimulation (PNFS) has been used with increased frequency as a minimally invasive and safe intervention for the management of intractable neuropathic postoperative pain. The objective of this retrospective study was to evaluate the efficacy of PNFS for treatment of chronic hip pain after THA and GTB. METHODS Twelve patients with chronic post-operative pain after THA and GTB underwent an uneventful PNFS trial with percutaneous placement of 2 temporary 8-electrode leads (Medtronic Inc, Minneapolis, Minn) positioned in the subcutaneous tissue in the area of greatest pain, parallel to postoperative scar over the affected upper lateral thigh. RESULTS After experiencing excellent pain relief over the next 2 days, the patients were implanted with permanent leads and rechargeable or non-rechargeable generator 2-4 weeks later. They reported sustained pain relief at 12-month follow-up visits. CONCLUSION PNFS provides an effective alternative treatment option for select patients with chronic postoperative pain after THA and GTB who have failed conservative treatment.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Ultrasound guided peripheral nerve stimulation implant for management of intractable pain after inguinal herniorrhaphy.

BACKGROUND Inguinal hernia repair is one of the most common operations performed worldwide. Intractable pain following this operation is a potential debilitating complication. The exact etiology of this complex pain is unknown and the treatment of chronic pain after inguinal herniorrhaphy can be a difficult task for both the patient and the clinician. OBJECTIVES The objectives of this study a...

متن کامل

Peripheral nerve stimulation in intractable neuropathic pain.

Peripheral nerve stimulation (PNS) is a neurostimulation analgesic technique. PNS is utilized to treat peripheral neuropathic pain. It is highly sophisticated and a specialized technique used where other forms of treatment have failed. This paper describes the PNS procedure, its therapeutic principles, indications, and the comprehensive care for patients after the PNS implant. First, we summari...

متن کامل

Effects of Cortical and Peripheral Electrical Stimulation on Brain Activity in Individuals with Chronic Low Back Pain

Purpose: Neuroscience studies suggest that Chronic Low Back Pain (CLBP) is associated with central sensitization, and maladaptive reorganization of the brain; this introduced a new target for LBP treatment. Studies revealed that cortical and peripheral electrical stimulation can be beneficial in regulating brain neuronal activity. However, there is a scarcity of evidence to support the effects ...

متن کامل

Peripheral nerve stimulation for trigeminal neuropathic pain.

Facial pain is a complex disease with a number of possible etiologies. Trigeminal neuropathic pain (TNP) is defined as pain caused by a lesion or disease of the trigeminal branch of the peripheral nervous system resulting in chronic facial pain over the distribution of the injured nerve. First line treatment of TNP includes management with anticonvulsant medication (carbamazepine, phenytoin, ga...

متن کامل

Continuous L2 ParavertebraL bLoCk for PostoPerative anaLgesia after DireCt anterior totaL HiP artHroPLasty: a Case series

Objective: the purpose of this case series was to assess the potential use of a continuous paravertebral block (Pvb) at the L2 nerve root level as a part of a multimodal regimen in patients undergoing direct anterior total hip arthroplasty (Da-tHa). Design: 20-patient case series. Setting: tertiary care hospital. Subjects: patients undergoing Da-tHa. Methods: We retrospectively analyzed 20 pati...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • WMJ : official publication of the State Medical Society of Wisconsin

دوره 109 3  شماره 

صفحات  -

تاریخ انتشار 2010