Ultrasound-Guided Percutaneous Peripheral Nerve Stimulation for the Treatment of Chronic Intractable Pain Originating From a Lipofibromatous Hamartoma of the Median Nerve

Guilherme Ferreira-Dos-Santos, Mark Friedrich B. Hurdle, Sahil Gupta, Salim M. Ghazi, Stephen D. Trigg, Steven R. Clendenen

Research output: Contribution to journalArticle

Abstract

This case report presents an application of peripheral nerve stimulation to the median nerve to treat a patient with intractable pain due to a lipofibromatous hamartoma of the left upper extremity. Ultrahigh-frequency ultrasound was used to determine the boundaries of the hamartoma. The patient then underwent an ultrasound-guided implantation of 2 stimulator electrodes distal to the elbow along the median nerve with stimulation coverage achieved at 1.2 and 1.4 mA, respectively. After an uneventful procedure, the pain score immediately decreased from 9 out of 10 to less than 6 on a numeric rating scale. Two weeks after the procedure, the patient reported substantial pain relief, with an average pain level of 5 to 6 out of 10. Twelve months after implantation, the patient maintained significant pain relief, rating her average pain level as a 4 to 6 out of 10. Placement of a percutaneous peripheral nerve stimulator was safe and effective with no adverse events being reported at the 12-month follow-up.

Original languageEnglish
JournalJournal of Hand Surgery
DOIs
Publication statusAccepted/In press - 2020

Keywords

  • case report
  • Chronic pain
  • neuropathic pain
  • percutaneous nerve stimulation
  • peripheral nerve stimulation

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