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Updated: May 3, 2026
Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
Published on: May 10, 2017
Costoclavicular Approach to the Infraclavicular Brachial Plexus for Peripheral Nerve Stimulation in Treating
Emma Fu1,2, Chase Beal1, Hesham Elsharkawy3
1MetroHealth Medical Center, Cleveland, OH.
Background:
In cases of complex regional pain syndrome (CRPS) that are refractory to conservative treatment, interventional therapies, such as neuromodulation, including peripheral nerve stimulation (PNS), may be considered as a treatment option. PNS has proven effective when applied to the brachial plexus. The anatomical positioning of the infraclavicular brachial plexus cords allows for targeting via either the conventional paracoracoid approach or the novel costoclavicular approach. The latter approach can be an excellent option to cover the plexus, as it clusters the brachial plexus cords at a more superficial level.
Case Report:
We present the case of a 58-year-old woman who developed type 2 CRPS following a work-related wrist injury. Initially, she had ulnar nerve and tendon injury for which she received a series of surgeries. After failing conservative therapy, she underwent PNS with significant relief.
Conclusions:
Our case demonstrates the successful use of PNS to the brachial plexus via the novel costoclavicular approach to the infraclavicular brachial plexus for the management of refractory CRPS.
