Spinal Cord Stimulation for Treatment of Chronic Pelvic Pain
Alexander E. Yakovlev, MD | Beth E. Resch, APNP
BACKGROUND AND AIMS
Patients with chronic pelvic pain may suffer from intractable pain along with functional incapacitation and often do not respond to conventional forms of treatment. Spinal cord stimulation (SCS) can be used to treat patients with pelvic pain syndromes when other interventional pain procedures fail.
MATERIALS AND METHODS
The patient is a 37-year-old male with history of work-related injury who sustained perineal laceration. After laceration repair he continued experiencing chronic pain in perineum, rectum and tailbone. He failed conservative treatment, lumbar sympathetic and ganglion impar blocks. He underwent successful trial of percutaneous placement of two 8-electrode epidural leads (Medtronic Inc., Minneapolis, MN). Epidural access was gained at the T12-L1 interspace with final leads positioned at T8-T9-T10. During SCS trial patient reported greater than 50% improvement in pain and two weeks later underwent placement of permanent leads and RestorePRIME non- rechargeable generator.
RESULTS
After final implantation, patient had excellent pain relief at 12 months. He discontinued use of all oral pain medications. The patient also reported other positive outcomes including the ability to return to social and occupational activities and improved family relationships.
FIGURES
CONCLUSION
SCS can be an effective option in the management of intractable pelvic pain related to trauma in selected patients who in the past exhausted all available treatments. This technique with comparatively low invasiveness is relatively easy to perform and a safe procedure for an otherwise intractable condition.
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