Spinal cord stimulation in the management of neuropathic pain in cancer patients: case report
Introduction: Neuropathic pain is present in up to 40 % of all cancer patients. A considerable number of patients fail to achieve enough pain relief with conventional treatment, which is why therapeutic alternatives such as spinal cord stimulation should be considered.
Case description and results: This is the case of a female patient with chronic neuropathic pain secondary to a partial femoral nerve injury sustained during resection and lymph node dissection surgery with curative intent for a large stage II cell squamous cell carcinoma T2N0M0, localized in the right popliteal fossa. The patient presented with difficult to manage chronic neuropathic pain, despite receiving multiple oral analgesics and nerve blocks. A medullary neurostimulator was implanted that relieved the patient’s pain intensity in up to 80%, in addition to improved function and quality of life.
Conclusions: spinal cord stimulation is considered an effective neuromodulatory intervention which has shown satisfactory results in the treatment of various types of refractory chronic pain in cancer patients, including neuropathic pain.
Boland E, Mulvey M. Classification of neuropathic pain in cáncer patients, Review. Curr Opin Support Palliat Care. 2015;9:112-5. doi: https://doi.org/10.1097/SPC.0000000000000136.
Edwards H, Mulvey M, Bennett M. Cancer-related neuropathic pain. Cancers. 2019;11(3):373. doi: https://doi.org/10.3390/cancers11030373
Jensen TS, Baron R, Haanpaa M, Kalso E, Loeser JD, Rice AS, Treede RD. A new definition of neuropathic pain. Pain. 2011;152:2204-5. doi: https://doi.org/10.1016/j.pain.2011.06.017
Pérez S, Acosta A. Consenso mexicano de manejo de dolor por cáncer. Gaceta Mexicana de Oncología. 2016;15(Supl 1):3-34.
Bennett MI, Rayment C, Hjermstad M, Aass N, Caraceni A, Kaasa S. Prevalence and aetiology of neuropathic pain in cancer patients: A systematic review. Pain. 2012;153:359-65. doi: https://doi.org/10.1016/j.pain.2011.10.028
Rayment C, Hjermstad MJ, Aass N, Kaasa S, Caraceni A, Strasser F, et al. Neuropathic cancer pain: Prevalence, severity, analgesics and impact from the European Palliative Care Research Collaborative-Computerised Symptom Assessment study. Palliat Med. 2013;27:714-21. doi: https://doi.org/10.1177/0269216312464408
Fallon M. Neuropathic pain in cáncer. Br J Anaesthesia. 2013;111(1):105-11. doi: https://doi.org/10.1093/bja/aet208
Flagg A, McGreevy K, Williams K. Spinal cord stimulation in the treatment of cancer-related pain: “Back to the Origins”. Curr Pain Headache Rep. 2012;16(4):343-9. doi: https://doi.org/10.1007/s11916-012-0276-9
Eisenberg E, Burstein Y, Suzan E. Spinal cord stimulation attenuates temporal summation in patients with neuropathic pain. PAIN. 2015;156(3):381-5. doi: https://doi.org/10.1097/01.j.pain.0000460342.69718.a2.
Zarranz JJ. Dolor. En: Neurología. Sexta edición. Elsevier España, S.L.U; 2018. p. 235-48.
Papuć E, Rejdak K. The role of neurostimulation in the treatment of neuropathic pain. Ann Agric Environ Med. 2013;20(1):14-7.
Deer T, Jain S, Hunter C, Chakravarthy K. Neurostimulation for intractable chronic pain. Brain Sci. 2019;9(2):23. doi: https://doi.org/10.3390/brainsci9020023
Cameron T. Safety and efficacy of spinal cord stimulation for the treatment of chronic pain: a 20-year literature review. J Neurosurg. 2004;100:254-67. doi: https://doi.org/10.3171/spi.2004.100.3.0254
Shealy CN, Mortimer JT, Reswick JB. Electrical inhibition of pain by stimulation of the dorsal columns: Preliminary clinical report. Anesth Analg. 1967;46:489-91.
Yakovlev AE, Ellias Y. Spinal cord stimulation as a treatment option for intractable neuropathic cancer pain. Clin Med Res. 2008;6(3-4):103-6. doi: https://doi.org/10.3121/cmr.2008.813
Yakovlev AE, Resch BE. Spinal cord stimulation for cancer-related low back pain. Am J Hosp Palliat Med. 2011;29(2):93-7. doi: https://doi.org/10.1177/1049909111410414
Yakovlev AE, Resch BE, Karasev SA. Treatment of cancer-related chest wall pain using spinal cord stimulation. Am J Hosp Palliat Med. 2010;27(8):552-6. doi: https://doi.org/10.1177/1049909110373240
Melzack R, Wall PD. Pain mechanisms: A new theory. Science. 1965;150(3699):971-8. doi: https://doi.org/10.1126/science.150.3699.971
Copyright (c) 2020 Sociedad Colombiana de Anestesiología y Reanimación (S.C.A.R.E.)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The Sociedad Colombiana de Anestesiología y Reanimación (S.C.A.R.E.) is the owner of all copyrights to any articles published in the journal. Published manuscripts become the permanent property of S.C.A.R.E. and may not be published elsewhere without written permission. S.C.A.R.E. keeps the right to use these manuscripts in any form, including print, video, audio and digital.
Creative Commons License
Open-access articles can be read, downloaded and shared on a free basis upon publication. The Journal publishes all articles under the CCBY- NC-ND license. Attribution-NonCommercial-NoDerivs: CC BY- NC-ND. Of the six main licenses, this is the most restrictive because it only allows others to download and share articles as long as they give credit to the author, but they cannot in any way change the paper or use it commercially.