Spinal Cord Stimulation in the Treatment of Postherpetic Neuralgia in Patients with Chronic Kidney Disease: A Case Series and Review of the Literature.
10.3344/kjp.2011.24.3.154
- Author:
In Yeob BAEK
;
Ju Yeon PARK
;
Hyae Jin KIM
;
Ji Uk YOON
;
Gyeong Jo BYOEN
;
Kyung Hoon KIM
- Publication Type:Original Article
- Keywords:
anticonvulsants;
kidney disease;
postherpetic neuralgia;
spinal cord;
therapeutic electric stimulation
- MeSH:
Anticonvulsants;
Electric Stimulation Therapy;
Follow-Up Studies;
Glomerular Filtration Rate;
Health Resorts;
Humans;
Kidney;
Kidney Diseases;
Neuralgia, Postherpetic;
Pain, Intractable;
Renal Insufficiency, Chronic;
Spinal Cord;
Spinal Cord Stimulation
- From:The Korean Journal of Pain
2011;24(3):154-157
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Postherpetic neuralgia (PHN) is usually managed pharmacologically. It is not uncommon for patients with chronic kidney disease (CKD) to suffer from PHN. It is difficult to prescribe a sufficient dose of anticonvulsants for intractable pain because of the decreased glomerular filtration rate. If the neural blockade and pulsed radiofrequency ablation provide only short-term amelioration of pain, spinal cord stimulation (SCS) with a low level of evidence may be used only as a last resort. This study was done to evaluate the efficacy of spinal cord stimulation in the treatment of PHN in patients with CKD. METHODS: PHN patients with CKD who needed hemo-dialysis who received insufficient relief of pain over a VAS of 8 regardless of the neuropathic medications were eligible for SCS trial. The follow-up period was at least 2 years after permanent implantation. RESULTS: Eleven patients received percutaneous SCS test trial from Jan 2003 to Dec 2007. Four patients had successfully received a permanent SCS implant with their pain being tolerable at a VAS score of less than 3 along with small doses of neuropathic medications. CONCLUSIONS: SCS was helpful in managing tolerable pain levels in some PHN patients with CKD along with tolerable neuropathic medications for over 2 years.
