Case Report

Successful spinal cord stimulation for neuropathic below-level spinal cord injury pain following complete paraplegia: a case report

  • Spinal Cord Series and Cases 3, Article number: 17049 (2017)
  • doi:10.1038/scsandc.2017.49
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Abstract

Introduction:

Neuropathic pain is common in patients with spinal cord injury (SCI) and often difficult to treat. We report a case where epidural spinal cord stimulation (SCS) below the level of injury has been successfully applied in a patient with a complete spinal cord lesion.

Case presentation:

A 53-year-old female presented with neuropathic below-level SCI pain of both lower legs and feet due to complete SCI below T5. Time and pain duration since injury was 2 years. Pain intensity was reported on numeric rating scale with an average of 7/10 (0 meaning no pain, 10 meaning the worst imaginable pain), but also with about 8–10 pain attacks during the day with an intensity of 9/10, which lasted between some minutes and half an hour. SCS was applied below the level of injury at-level T11-L1. After a successful 2 weeks testing period the pulse generator has been implanted permanently with a burst-stimulation pattern. The average pain was reduced to a bearable intensity of 4/10, in addition attacks could be reduced both in frequency and in intensity. This effects lasted for at least three months of follow-up.

Discussion:

Even in case of complete SCI, SCS might be effective. Mechanisms of pain relief remain unclear. A modulation of suggested residual spinothalamic tract function may play a role. Further investigation has to be carried out to support this theory.

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Author information

Affiliations

  1. Centre for Pain Medicine, Swiss Paraplegic Centre, Nottwil, Switzerland

    • Tim A Reck
    •  & Gunther Landmann

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Competing interests

The authors declare no conflict of interest.

Corresponding author

Correspondence to Tim A Reck.