Treatment of chronic pain by spinal cord stimulation

Chronic pain after injury of the nervous system is difficult to treat. This report describes our experience in the treatment of chronic pain by spinal cord stimulation (SCS) in four patients (three men and one woman, with ages ranging from 61 to 73 yr). One patient had chronic intractable pain due to a spinal cord injury, one had post-herpetic neuralgia, one had failed back surgery syndrome, and one had brachial plexus and spinal cord injuries. A permanent spinal cord stimulator was implanted in the patient with spinal cord injuries. In the other three patients, a permanent spinal cord stimulator was implanted after a successful trial stimulation with temporarily implanted electrodes. After 19 to 25 months (mean, 21 mo) of follow-up, three patients had satisfactory improvement of pain and one patient had temporary pain relief, but pain recurred two months after implantation. One patient had recurrence of pain after migration of an electrode, and the pain-relieving effects of SCS returned after repositioning the electrode. According to this preliminary experience, SCS is effective for pain reduction in selected patients with chronic pain. Long-term follow-up is mandatory to evaluate the benefits and complications of SCS for relief of chronic pain.