Open AccessCervical Spinal Cord Stimulation with 5-Column Paddle Lead In Raynaud’s Disease
Author(s) -
Mohammed Issa,
Chong H Kim
Publication year - 2012
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.2012/15/303
Subject(s) - medicine , spinal cord stimulator , spinal column , surgery , lead (geology) , lumbar , spinal cord stimulation , spinal cord , stimulation , anesthesia , geomorphology , psychiatry , geology
Objective: To report a case of Raynaud disease and its successful treatment withspinal cord stimulation utilizing the newly designed five-column Penta™ lead paddle.Specific electrode design, programming characteristics, and surgical technique are alsodiscussed in this case.Design: Case Report.Setting: University pain management center.Background: A 65-year-old man with Raynaud disease presented with neck and upperextremity pain. The patient also had herniation and spondylosis of the lumbar spineand intervertebral disc disease of the cervical spine. An examination revealed venouschanges, chronic ulceration, and digit discoloration in upper and lower extremities.Method: Conservative management and pharmacological treatment were ineffective.Sympathetic block produced significant but limited improvement. Treatment with spinalcord stimulation was tried after a successful 7-day trial.Results: Initial stimulation of the cervical spine with two octapolar leads at theC2 level produced greater than 75% pain improvement. However, the patient lostcoverage shortly after discharge due to lead migration which could not be regainedwith reprogramming. A revision with Penta™ lead paddles produced sustainable andsignificant paresthesia coverage.Limitations: A case report.Conclusion: We report the successful application of spinal cord stimulation utilizing afive-column paddle lead in an individual with severe refractory Raynaud disease.Key words: Keywords: Spinal cord stimulation, Penta lead, five-column lead,electrode, paresthesia, Raynaud disease, cervical pain, programming.