Peripheral nerve stimulation - Outcome Medical of Georgia

J.N. Campbell and D. Ni. LorTABLEResultsof peripheral tierve stimulator irnplanta in the University of tIhnesuta .ccriesAgeSnrnuIiturDiagnosisComplicationsResultFollow-U47 NI uhiar gunshot wound innone excellent 68elbow ulnar palsy42 ulnar ulnar pain fromnone excellent 63olecranon fracture42 ulnar tardy ulnar palsy none excellent 4641 ulnar tardy ulnar palsy none xccllent 5419 sciatic hip dislocationsciaticinjurynone partial 44successnone failure 4459 sciatic spine injurysciatic palsy31 brachial traumatic amputationof arm stump pain57 brachial traumatic amputationof arm stump pain64 sciatic amputation above theknee vascular diseaseneuropathy stumpinfectionremovedPNSthen failurerecent 44reimplantedwire disconnected initially excellentrcimplantedlost to follow-upmuscle movement failure 48with stimulation10 63 sciatic andfemoralpainleg trauma stump pain none failure 54Patientswere asked to characterize theirpain in termsof variouscharacteristicssuchas steady pulsating hot burning heavypressing aching. Patientsin either the partialsuccessor excellent category more oftencharacterized their pain as sharp and stabbing six patientsas compared to patientsinthe failure group one patient. Two patientsin the excellent result group had hypercsthesiasas major problem and thesedisappeared with stimulation. Power outputrequirementsfrom the transmitter did notincrease with time as has been noted withdorsal column stimulation5t although thefollow-up period is too short for thistoconclusive.Muscle cramping from stimulation did notoccur in any of the patientsin either of thesuccessgroups. Furthermore these patientsdid not find the stimulation distracting butrather that with the reduction in pain theyhad better ability to concentrate. Pain relieflastedfor variousbelengthsof time after givenstimulation period. In three patientsthe painbegan again as soon as stimulation stoppedin twootherspainreturned within 30 to 60minutesand in four otherspain returnedtohours.Patientsdenied that the stimulation interfercd with walking coordination sexualinfunctioning driving sensation or musculstrength. These patientsreported no tissuejuryresult.ofin the stimulated limbanalgesia.or elsewhereUniversity of Minnesota SeriesIn 1973 seriesof 10patientswithchrornerve injury treated with PNS implantsdescribed. At that time six patientsjudged to have excellent resultswhilehad good resultsand two were treatmefailures. Now yearslater one ofpatientsin the excellent result serieshas belost to follow-up while another has becomcfailure.Thislatter patient who hadtraumatic arm amputation continuedreceive stimulation into the painful areano longer obtainspain relief. The longefollow-up period is in two of the patientswiexcellentweresultswho have now been using.nar nerve stimulatorsfor yearsand cctinue to obtain complete pain relief. Theresultsarc summarized in Table 2.DiscussionThe best predictor for successin usingPNS implant in the treatment of intractabpain was the patientsdiagnosis. No patietreated with sciatic implant for the low ba696 J. Neurosurg. Volume 45 December 19sois