Peripheral nerve stimulation: a percutaneous minimally invasive approach

We report on the use of a new percutaneous technique for peripheral nerve stimulation (PNS) treatment of chronic pain. A 56-year-old woman was diagnosed with algodystrophic syndrome, now called Complex Regional Pain Syndrome, type 2 (CRPS2), due to a lesion of the right medial nerve despite surgical revascularization, angioplasty and stent insertion. After a successful 10-day trial of PNS via a percutaneous quadripolar lead in the interscaline space, an implantable pulse generator was implanted in the abdominal subcutaneous tissue and connected to the subcutaneous lead via an extension. After one year of follow-up, the patient was still experiencing good pain relief. We conclude that this novel percutaneous PNS technique offers the advantage of being a minimally invasive approach that can be easily adopted for the management of chronic pain.