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Korean J Pain. 2011 Sep;24(3):154-7. doi: 10.3344/kjp.2011.24.3.154. Epub 2011 Sep 6.

Spinal cord stimulation in the treatment of postherpetic neuralgia in patients with chronic kidney disease: a case series and review of the literature.

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  • 1Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Busan, Korea.

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.

KEYWORDS:

anticonvulsants; kidney disease; postherpetic neuralgia; spinal cord; therapeutic electric stimulation

PMID:
21935494
[PubMed]
PMCID:
PMC3172329
Free PMC Article
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