Peripheral nerve field stimulation for chronic pain: 100 cases and review of the literature

Abstract

Objective: To evaluate the clinical outcomes of 100 consecutive patients receiving peripheral nerve field stimulation (PNFS) for the treatment of chronic intractable pain.

Design: Prospective, observational study.

Setting: A private interventional pain specialty referral practice.

Patients: One hundred consecutive private practice patients receiving PNFS for the treatment of chronic craniofacial, thorax, lumbosacral, abdominal, pelvic, and groin pain conditions.

Outcome measures: Pain (11-point numerical rating scale), complications, changes to analgesic use and employment status, disability (Oswestry or Neck Disability Indexes), depression (Zung Depression Index), and patient satisfaction.

Results: We demonstrate an average pain reduction of 4.2 ± 2.5 pain scale points on an 11-point scale following PNFS (preimplant pain score of 7.4 ± 1.7 to a follow-up average of 3.2 ± 2.3 pain scale points) (P≤0.00). At a follow-up period of 8.1 ± 4.7 months (range 1-23 months), an overall 72% of patients reduced their analgesic use following PNFS. Patients receiving a lumbosacral PNFS for chronic low back pain reported a significant reduction in disability following treatment, as determined by the Oswestry Disability Index. Of the 100 cases, no long-term complications were reported.

Conclusions: This prospective 100 consecutive PNFS patient outcome study demonstrates that PNFS can be a safe and effective treatment option for, otherwise, intractable chronic pain conditions. PNFS has the potential to fundamentally change the way we think about pain management.