Successful use of differential target multiplexed spinal cord stimulation for chronic postsurgical abdominal pain

Abstract

Introduction: Recent advances in stimulation techniques have improved the efficacy and expanded the applicability of spinal cord stimulation (SCS). Among these techniques, there are no reports on the efficacy of differential target multiplexed (DTM) SCS for chronic postsurgical pain (CPSP) after abdominal surgery. Therefore, we present the successful use of DTM SCS for CPSP after distal pancreatectomy.

Methods: A 49-year-old man with hypertension and severe chronic low back pain presented with neuropathic CPSP involving the left abdomen in the area of a laparotomy incision. His pain was refractory to conservative treatment and was rated 10 on a numerical rating scale (NRS). He underwent permanent implantation of a pulse generator after a 14-day trial stimulation.

Results: Chronic postsurgical pain was well controlled (NRS 1-2) at a 3-month follow-up with DTM SCS.

Conclusion: Differential target multiplexed SCS can be a new treatment option for neuropathic CPSP that is resistant to conservative treatment. It is important to further examine the characteristics of CPSP and identify appropriate candidates for the successful use of DTM SCS.

Keywords: Chronic postsurgical pain; Differential target multiplexed stimulation; Neuropathic pain; Spinal cord stimulation.

Figure 1.

Anteroposterior (A) and lateral (B) view of two 8-contact leads. The tips of the leads were placed at the bottom of the T7 vertebral body. This image represents the final placement of the leads. Differential target multiplexed stimulation consisted of a base signal (frequency, 50 Hz; pulse width 200 μs) and other 3 programs of prime signals (frequency, 300 Hz; pulse width 170 μs).