Peripheral nerve field stimulation following dorsal root entry zone lesion: a technical note

Area of Science:

• Neurology
• Pain Management
• Neurosurgery

Background:

• Peripheral nerve field stimulation (PNFS) is effective for localized refractory pain.
• Upper limb PNFS is challenging due to lead displacement risks from joint mobility.
• Neuropathic pain often requires advanced treatment modalities.

Purpose of the Study:

• To describe a novel two-step lead placement technique for upper limb PNFS.
• To evaluate the efficacy and safety of this technique in a patient with refractory neuropathic pain.
• To address the limitations of PNFS in the upper extremities.

Main Methods:

• A 58-year-old male patient with refractory neuropathic pain was treated.
• A two-step electrode lead placement approach was utilized for PNFS.
• The patient had a history of dorsal root entry zone lesion and favorable response to TENS.

Main Results:

• The patient achieved over 50% pain relief at 1-year follow-up.
• No lead displacement or resistance was observed during upper limb movements.
• The technique demonstrated successful management of upper limb neuropathic pain.

Conclusions:

• The described two-step lead placement technique is a viable solution for upper limb PNFS.
• This method effectively mitigates lead displacement issues in mobile segments.
• PNFS can be successfully applied to manage refractory upper limb neuropathic pain.