Spinal Cord Stimulation for Treatment of Alcoholic Neuropathy; A Case Report
Victoria Yakovleva, MD, Alexander E. Yakovlev, MD, Comprehensive Pain Management of The Fox Valley, SC, Appleton, Wisconsin, USA
INTRODUCTION
Patients with alcoholic neuropathy may suffer from intractable pain in the extremities and functional incapacitation despite conventional medical treatment and physical therapy. Spinal cord stimulation (SCS) has been used to treat patients with pain in the upper and lower extremities related to peripheral neuropathy from different causes.
MATERIALS AND METHODS
The patient is a 46 year old female with history of chronic bilateral leg pain related to alcoholic neuropathy who failed conservative treatment and sympathetic blocks. She underwent successful trial of percutaneous placement of two 8-electrode epidural leads. Epidural access was gained at the L1/L2 interspace with final lead positioning at T9-T10-T11. During SCS trial patient reported greater than 50% improvement of the pain and two weeks later underwent placement of permanent leads and RestorePRIME (Medtronic Inc., Minneapolis, MN) non- rechargeable generator.
RESULTS
After final implantation, patient had excellent pain relief at 12 months. She discontinued use of all oral pain medications. She had improvement of functional capacity. The patient’s walking distance increased from less than 30m to more than 400m.
IMAGE
CONCLUSION
SCS can be an effective option in the management of intractable pain related to alcoholic neuropathy. In select patients who in the past exhausted all available treatments, SCS lead to functional improvement. This technique with comparatively low invasiveness is relatively easy to perform. It is a safe procedure for this intractable condition.
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