We experienced a case of chronic pain responding to electrical acupuncture therapy while on spinal cord stimulation. A 35 year-old male presented with chronic neck pain. At 16 years of age, he had neck pain due to traffic accident with stellate ganglion block and epidural block. At 29 years of age, he sensed radiating pain in the 3rd to 5th digits of the left hand during epidural block. At 33 years of age, nerve root injury occurred after insertion of an epidural catheter, resulting in epidural abscess. Although the abscess resolved after antibiotic treatment, he had stiff fingers in the left hand together with neck pain and restricted range of motion of the neck. At 34 years of age, a spinal cord stimulation device was inserted which improved the stiff fingers in the left hand, but not the neck pain and restricted neck motion. He therefore visited our institute. At presentation, neck pain together with dysphagia and mastication pain were observed, and the patient was on a liquid diet. He was given electrical acupuncture treatment in additional to trigger point block and stellate ganglion laser. After two treatments, he was able to resume a normal diet. With reduced neck pain, he also undergo rehabilitation mainly through voluntary neck movements. This case demonstrates that electrical acupuncture treatment may be safe and effective for patients fitted with spinal cord stimulation device.

The factors that influence the risk of accidents during the replacement of gastrostomy catheters remain unknown and therefore have not yet been thoroughly investigated. We conducted a nationwide questionnaire survey of 415 rehabilitation-training facilities for the replacement of gastrostomy catheters. We received 221 valid responses. Among the catheter replacement methods submitted, the bumper button replacement method was the most widely chosen, comprising 40% of the valid responses. The measures used to prevent accidental erroneous catheterization included examination of the stomach contents, endoscopic examination of the stomach, and the detection of insufflation sounds, although these measures varied widely among the facilities. Fifty-one out of the 221 facilities that responded to the survey experienced various mishaps, of which 20 were due to erroneous catheterization. In approximately 40% of the facilities, there was no operative manual for the replacement nor was the patient's consent taken before performing the procedure. This investigation elucidates the risks involved in the replacement of gastrostomy catheters. This survey also suggests that the methods used for catheter replacement should be re-examined to prevent accidents during the replacement.