Spinal cord stimulation as a treatment option for intractable neuropathic cancer pain

Abstract

Nearly 6,750,000 people suffer moderate to severe cancer-related pain each year. Unfortunately, 10% to 15% of these patients fail to achieve acceptable pain relief with conventional management. Spinal cord stimulation (SCS) has been used with increased frequency for successful treatment of intractable cancer pain. We present two cases of intractable, refractory-to-conventional treatment cancer pain that were successfully treated with SCS. Case 1 reports a 51-year-old male with burning pain at the left groin site of inguinal metastases, post-surgical and intraoperative radiation therapy for treatment of squamous cell carcinoma of the anus. Case 2 reports a 43-year-old woman with intractable, burning, throbbing, and shooting pain, post-debulking followed by radiation of a metastatic colon carcinoma. In both cases SCS implantation provided 90% to 100% pain relief, improved functioning and sleep, and discontinuation of pain medications, sustained through 12 months.

Figure 1.

Thoracic epidural placement of two quadripolar leads showing the electrodes in a staggered position with tips at T-8.

Figure 2.

Thoracic epidural placement of two quadripolar leads showing the electrodes in a staggered position with tips at T-9.