Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Spinal Cord Stimulation for Intractable Visceral Pain due to Chronic Pancreatitis

  • Kim, Jin-Kyung (Departments of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hong, Seok-Ho (Departments of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Myung-Hwan (Departments of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Jung-Kyo (Departments of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine)
  • Published : 2009.08.28
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Abstract

Pain caused by chronic pancreatitis is medically intractable and resistant to conventional interventional or surgical treatment. We report a case of spinal cord stimulation (SCS) for intractable pain due to chronic pancreatitis. The patient had a history of nonalcoholic chronic pancreatitis and multiple emergency room visits as well as repeated hospitalization including multiple nerve block and morphine injection for 3 years. We implanted surgical lead at T6-8 level on this patient after successful trial of percutaneous electrode. The patient experienced a decreased visual analog scale (VAS) scores for pain intensity and amount of opioid intake. The patient was followed for more than 14 months with good outcome and no further hospitalization. From our clinical case, spinal cord stimulation on intractable pain due to chronic pancreatitis revealed moderate pain control outcome. We suggest that SCS is an effective, noninvasive treatment option for abdominal visceral pain. Further studies and long term follow-up are needed to fully understand the effect of SCS on abdominal visceral pain.

Keywords

References

  1. Dimcevski G, Sami SA, Funch-Jensen P, Le Pera D, Valeriani M,Arendt-Nielsen L, et al. : Pain in chronic pancreatitis : the role ofreorganization in the central nervous system. Gastroenterology 132 :1546-1556, 2007 https://doi.org/10.1053/j.gastro.2007.01.037
  2. Fregni F, Pascual-Leone A, Freedman SD : Pain in chronic pancreatitis :a salutogenic mechanism or a maladaptive brain response? Pancreatology7 : 411-422, 2007 https://doi.org/10.1159/000108958
  3. Kapural L, Narouze SN, Janicki TI, Mekhail N : Spinal cord stimulationis an effective treatment for the chronic intractable visceral pelvicpain. Pain Med 7 : 440-443, 2006 https://doi.org/10.1111/j.1526-4637.2006.00165.x
  4. Kapural L, Rakic M : Spinal cord stimulation for chronic visceral painsecondary to chronic non-alcoholic pancreatitis. J Clin Gastroenterol42 : 750-751, 2008 https://doi.org/10.1097/01.mcg.0000225647.77437.45
  5. Khan YN, Raza SS, Khan EA : Application of Spinal Cord Stimulationfor the Treatment of Abdominal Visceral Pain Syndromes : CaseReports. Neuromodulation 8 : 14-27, 2005 https://doi.org/10.1111/j.1094-7159.2005.05216.x
  6. Krames ES, Foreman R : Spinal Cord Stimulation Modulates VisceralNociception and Hyperalgesia via the Spinothalamic Tracts and thePostsynaptic Dorsal Column Pathways : A Literature Review andHypothesis. Neuromodulation 10 : 224-237, 2007 https://doi.org/10.1111/j.1525-1403.2007.00112.x
  7. Kumar K, Hunter G, Demeria D : Spinal cord stimulation in treatmentof chronic benign pain : challenges in treatment planning and presentstatus, a 22-year experience. Neurosurgery 58 : 481-496; discussion481-496, 2006 https://doi.org/10.1227/01.NEU.0000192162.99567.96
  8. Lee AW, Pilitsis JG: Spinal cord stimulation : indications and outcomes.Neurosurg Focus 21 : E3, 2006
  9. Melzack R, Wall PD : Pain mechanisms : a new theory. Science 150 :971-979, 1965 https://doi.org/10.1126/science.150.3699.971
  10. Nauta HJ, Soukup VM, Fabian RH, Lin JT, Grady JJ, WilliamsCG, et al. : Punctate midline myelotomy for the relief of visceral cancerpain. J Neurosurg (2 Suppl) 92 : 125-130, 2000
  11. North RB, Kidd DH, Olin JC, Sieracki JM : Spinal cord stimulationelectrode design : prospective, randomized, controlled trial comparingpercutaneous and laminectomy electrodes-part I : technical outcomes.Neurosurgery 51 : 381-389; discussion 389-390, 2002 https://doi.org/10.1097/00006123-200208000-00015
  12. Palecek J : The role of dorsal columns pathway in visceral pain.Physiol Res 53 Suppl 1 : S125-S130, 2004
  13. Qin C, Lehew RT, Khan KA, Wienecke GM, Foreman RD : Spinalcord stimulation modulates intraspinal colorectal visceroreceptivetransmission in rats. Neurosci Res 58 : 58-66, 2007 https://doi.org/10.1016/j.neures.2007.01.014
  14. Stacey B, colantonio A, Vookles JL, Sibell D, Kulawiak L : Managementof pain by anesthetic techniques, in Winn HR (ed) : YoumansNeurological Surgery Fifth edition : Saunders, 2004, Vol 3, p 2983
  15. Sundaraj SR, Johnstone C, Noore F, Wynn P, Castro M : Spinal cordstimulation : a seven-year audit. J Clin Neurosci 12 : 264-270, 2005 https://doi.org/10.1016/j.jocn.2004.06.010
  16. Tiede JM, Ghazi SM, Lamer TJ, Obray JB : The use of spinal cordstimulation in refractory abdominal visceral pain: case reports andliterature review. Pain Pract 6 : 197-202, 2006 https://doi.org/10.1111/j.1533-2500.2006.00085.x
  17. Villavicencio AT, Leveque JC, Rubin L, Bulsara K, Gorecki JP :Laminectomy versus percutaneous electrode placement for spinal cordstimulation. Neurosurgery 46 : 399-405; discussion 405-406, 2000 https://doi.org/10.1097/00006123-200002000-00025

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