Spinal cord stimulation in patients suffering from chronic pain after surgery for spinal intradural tumors: A case report and literature summary

Pain Practice, 2022 · DOI: 10.1111/papr.13156 · Published: July 1, 2022

Simple Explanation

This case report discusses a 57-year-old female who experienced chronic neuropathic pain in both legs after surgical removal of a spinal intradural meningioma. The pain significantly impacted her quality of life, and conventional treatments were ineffective. Spinal cord stimulation (SCS) was successfully implanted at the Th5 level to manage the central neuropathic pain. After 36 months of follow-up, the patient experienced significant pain relief and a near-complete cessation of analgesic medications. The authors reviewed existing literature and found limited evidence on SCS for pain related to intradural spinal tumors. The case report suggests that SCS can be a beneficial treatment option, even with stimulation above or below the lesion.

Study Duration

36 months

Participants

One 57-year-old female

Evidence Level

Level 4: Case Report and Literature Review

Key Findings

1
Spinal cord stimulation (SCS) at the Th5 level resulted in significant pain relief for a patient with chronic neuropathic pain following the removal of a Th7 meningioma.
2
The patient experienced an 80% reduction in pain four months after permanent SCS implantation, along with a reduction in analgesic intake.
3
Literature review indicates that SCS can be effective for neuropathic pain after intradural tumor resection, with successful outcomes reported for electrode placements both above and below the lesion.

Research Summary

This case report presents a successful application of spinal cord stimulation (SCS) in a patient suffering from chronic neuropathic pain after surgical removal of a spinal intradural meningioma. The patient experienced significant pain relief and reduced analgesic intake following SCS implantation. A literature review was conducted to assess the prevalence of neuropathic pain and the efficacy of SCS in treating pain after the surgical removal of spinal intradural tumors. The review revealed a limited number of case reports describing the use of SCS in this patient population. The study suggests that SCS can be a viable treatment option for central neuropathic pain following intradural tumor resection. Further research is needed to determine the optimal electrode placement and confirm the efficacy of SCS in this specific patient population.

Practical Implications

Clinical Practice

Consider SCS as a potential treatment option for patients experiencing chronic neuropathic pain after spinal intradural tumor resection, especially when conservative treatments fail.

Surgical Planning

Be aware of the potential for post-surgical neuropathic pain after spinal intradural tumor removal, particularly with intramedullary tumors.

Future Research

Conduct further research to determine the optimal SCS electrode placement (above or below the lesion) for pain management after intradural tumor resection.

Study Limitations

1
Single case report limits generalizability.
2
Literature review reveals a limited number of relevant studies.
3
Pathophysiology of pain after intradural tumor surgery is not well understood.

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