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Peripheral Nerve Stimulation Implant for Chronic Posttraumatic Hip and Pelvic Pain: A Case Report
Hesham Elsharkawy1, Nicolas M Mas D Alessandro2,3, Marianne Tanios2,3
1Department of Anesthesiology, Pain, and Healing Center, MetroHealth Professor of Anesthesiology, Physical Medicine, and Rehabilitation, Case Western Reserve University, Outcomes Research Consortium, Houston, TX.
Background:
Chronic hip and pelvic pain following trauma can be challenging to treat, particularly when pain originates from multiple nerve distributions. Traditional treatments often provide limited relief; peripheral nerve stimulation is a minimally invasive alternative.
Case Report:
A 68-year-old woman with persistent pelvic and hip pain following a right iliac wing fracture reported minimal response to medications and injections. Diagnostic nerve blocks targeting the obturator nerve, femoral sensory branches, and middle cluneal nerve, provided significant but short-term pain relief. A peripheral nerve stimulation trial targeting the middle cluneal, obturator, and femoral nerves resulted in a 75% reduction in pain. Following permanent implantation, a revision was required due to lead migration. Post revision, pain levels stabilized at 3-4/10 across both anterior and posterior pain distributions, with sustained improvement at 12 months.
Conclusion:
This case demonstrates the feasibility and sustained benefit of externally powered peripheral nerve stimulation for chronic posttraumatic hip and pelvic pain.
