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Journal of Neurorestoratology  2020, Vol. 8 Issue (3): 132-137    doi: 10.26599/JNR.2020.9040012
Case Report     
High-frequency spinal cord stimulation for treating pain in the lower limbs accompanied by bilateral para-anesthesia: A case report
Zhuqiang Cheng, Hongjun Liu, Hongmei Zhu, Yi Jin(✉)
Department of Pain Treatment, Nanjing Jinling Hospital, Nanjing 210002, Jiangsu, China
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Abstract  

A 46-year-old female patient experienced severe pain in both lower limbs following a traffic accident in 2008. The pain mainly presented in her feet; she also experienced sensory impairment, convulsions, and exercise function disorders. She was diagnosed with neuropathic pain, and no medicine had any remarkable effect. Therefore, spinal cord stimulation (SCS) was performed in October 2019. Her pain did not reduce after the initial adoption of conventional SCS until the application of high frequency SCS (HF-SCS). At the 6-month follow-up, the pain in her lower limbs was considerably reduced, lower limb motor function was slightly improved, and muscle twitching in both feet disappeared.



Key wordshigh-frequency      spinal cord stimulation      neuropathic pain      para-anesthesia     
Received: 01 May 2020      Published: 17 August 2020
Corresponding Authors: Yi Jin   
Cite this article:

Zhuqiang Cheng, Hongjun Liu, Hongmei Zhu, Yi Jin. High-frequency spinal cord stimulation for treating pain in the lower limbs accompanied by bilateral para-anesthesia: A case report. Journal of Neurorestoratology, 2020, 8: 132-137.

URL:

http://jnr.tsinghuajournals.com/10.26599/JNR.2020.9040012     OR     http://jnr.tsinghuajournals.com/Y2020/V8/I3/132

Fig. 1The radiography images showing the implant position of the spinal cord stimulation electrodes, and the internal fixations for L1 vertebral body fracture and L4 spondylolisthesis.
[1]   Slavin KV. History of peripheral nerve stimulation. Prog Neurol Surg. 2011, 24: 1-15.
[2]   Nashold B, Somjen G, Friedman H. Paresthesias and EEG potentials evoked by stimulation of the dorsal funiculi in man. Exp Neurol. 1972, 36(2): 273-287.
[3]   Hosobuchi Y, Adams JE, Weinstein PR. Preliminary percutaneous dorsal column stimulation prior to permanent implantation. J Neurosurg. 1972, 37(2): 242-245.
[4]   Song ZY, Viisanen H, Meyerson BA, et al. Efficacy of kilohertz-frequency and conventional spinal cord stimulation in rat models of different pain conditions. Neuromodulation. 2014, 17(3): 226-235.
[5]   Meier K. Spinal cord stimulation: Background and clinical application. Scand J Pain. 2014, 5(3): 175-181.
[6]   Cui JG, Linderoth B, Meyerson BA. Effects of spinal cord stimulation on touch-evoked allodynia involve GABAergic mechanisms. An experimental study in the mononeuropathic rat. Pain. 1996, 66(2/3): 287-295.
[7]   Stiller CO, Cui JG, O'Connor WT, et al. Release of Gamma-aminobutyric acid in the dorsal horn and suppression of tactile allodynia by spinal cord stimulation in mononeuropathic rats. Neurosurgery. 1996, 39(2): 367-375.
[8]   Song ZY, Meyerson BA, Linderoth B. Muscarinic receptor activation potentiates the effect of spinal cord stimulation on pain-related behavior in rats with mononeuropathy. Neurosci Lett. 2008, 436(1): 7-12.
[9]   Schechtmann G, Song ZY, Ultenius C, et al. Cholinergic mechanisms involved in the pain relieving effect of spinal cord stimulation in a model of neuropathy. Pain. 2008, 139(1): 136-145.
[10]   Song ZY, Meyerson BA, Linderoth B. Spinal 5-HT receptors that contribute to the pain-relieving effects of spinal cord stimulation in a rat model of neuropathy. Pain. 2011, 152(7): 1666-1673.
[11]   Hanai F. C fiber responses of wide dynamic range neurons in the spinal dorsal horn. Clin Orthop Relat Res. 1998(349): 256-267.
[12]   Cui JG, O'Connor WT, Ungerstedt U, et al. Spinal cord stimulation attenuates augmented dorsal horn release of excitatory amino acids in mononeuropathy via a GABAergic mechanism. Pain. 1997, 73(1): 87-95.
[13]   Song Z, Ansah OB, Meyerson BA, et al. Exploration of supraspinal mechanisms in effects of spinal cord stimulation: role of the locus coeruleus. Neuroscience. 2013, 253: 426-434.
[14]   Shealy CN. Dorsal column electrohypalgesia. Headache. 1969, 9(2): 99-102.
[15]   van Buyten JP, Al-Kaisy A, Smet I, et al. High-frequency spinal cord stimulation for the treatment of chronic back pain patients: results of a prospective multicenter European clinical study. Neuromodulation. 2013, 16(1): 59-66.
[16]   Tiede J, Brown L, Gekht G, et al. Novel spinal cord stimulation parameters in patients with predominant back pain. Neuromodulation. 2013, 16(4): 370-375.
[17]   Al-Kaisy A, van Buyten JP, Smet I, et al. Sustained effectiveness of 10 kHz high-frequency spinal cord stimulation for patients with chronic, low back pain: 24-month results of a prospective multicenter study. Pain Med. 2014, 15(3): 347-354.
[18]   Kilgore KL, Bhadra N. Nerve conduction block utilising high-frequency alternating current. Med Biol Eng Comput. 2004, 42(3): 394-406.
[19]   Kilgore KL, Bhadra N. Reversible nerve conduction block using kilohertz frequency alternating current. Neuromodulation. 2014, 17(3): 242-255.
[20]   Kent AR, Weisshaar CL, Venkatesan L, et al. Burst & high-frequency spinal cord stimulation differentially effect spinal neuronal activity after radiculopathy. Ann Biomed Eng. 2020, 48(1): 112-120.
[21]   Lempka SF, McIntyre CC, Kilgore KL, et al. Computational analysis of kilohertz frequency spinal cord stimulation for chronic pain management. Anesthesiology. 2015, 122: 1362-1376.
[22]   Cuellar JM, Alataris K, Walker A, et al. Effect of high-frequency alternating current on spinal afferent nociceptive transmission. Neuromodulation. 2013, 16(4): 318-327.
[23]   Ahmed S, Yearwood T, de Ridder D, et al. Burst and high frequency stimulation: underlying mechanism of action. Expert Rev Med Devices. 2018, 15(1): 61-70.
[24]   Liao WT, Tseng CC, Wu CH, et al. Early high-frequency spinal cord stimulation treatment inhibited the activation of spinal mitogen-activated protein kinases and ameliorated spared nerve injury-induced neuropathic pain in rats. Neurosci Lett. 2020, 721: 134763.
[25]   McMahon S, Jones M, Lee D, et al. Effects of 10 kHz spinal cord stimulation on painmodel rodent deep dorsal horn neuronal excitability. In North American Neuromodulation Society’s 21st Annual Meeting, Las Vegas, USA, 2018.
[26]   Kowalski KE, Romaniuk JR, Kowalski T, et al. Effects of expiratory muscle activation via high-frequency spinal cord stimulation. J Appl Physiol. 2017, 123(6): 1525-1531.
[27]   DiMarco AF, Kowalski KE. High-frequency spinal cord stimulation in a subacute animal model of spinal cord injury. J Appl Physiol. 2019, 127(1): 98-102.
[28]   Abejon D, Rueda P, Vallejo R. Threshold evolution as an analysis of the different pulse frequencies in rechargeable systems for spinal cord stimulation. Neuromodulation. 2016, 19(3): 276-282.
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