Lumbar Neuromodulation for Chronic Pain and Postural Stability in a Spinal Cord Injured Patient: A Case Report

Peripheral nerve stimulation (PNS) is an evolving therapy for treating chronic refractory pain; however, limited clinical evidence is available for the use of PNS for chronic low back pain in the spinal cord injured (SCI) patient.

A patient, with an L1 complete SCI with a zone of partial preservation to S1 resulting in paraplegia and chronic low back pain, received bilateral L4 medial branch PNS. He had significant improvement of low back pain quantified by reductions in the Oswestry Disability Index and the Global Pain Scale, with additional benefits, including improved wheelchair sitting endurance and improved postural stability, at one-month and 2-month follow-up visits.

Despite limited evidence, our findings suggest lumbar medial branch PNS is a safe and viable option for treatment of chronic low back pain in the SCI population, with additional benefits of efferent fiber stimulation leading to improved postural stability and sitting tolerance.