The Use of Peripheral Nerve Stimulation in Conjunction with TMR for Neuropathic Pain

This case report discusses the combined use of targeted muscle reinnervation (TMR) and a peripheral nerve stimulator to manage neuropathic pain in an amputee. The patient, who had undergone a previous amputation with osseointegrated implant and regenerative peripheral nerve interfaces, experienced significant pain relief with the activation of the implanted nerve stimulator after the TMR procedure. The nerve stimulator is placed adjacent to the nerve transfer to target the most symptomatic nerve, potentially improving prosthetic use and quality of life.

• 1
  The patient reported a decrease in pain score from eight to four upon activation of the nerve stimulator postoperatively.
• 2
  Intraoperative placement of the nerve stimulator during TMR allows for accurate placement and securing of the device adjacent to the targeted nerve.
• 3
  Combining TMR with peripheral nerve stimulation represents a novel approach to managing postamputation neuropathic pain.