Multicolumn Spinal Cord Stimulation for Solitary Perineal Pain : A Case Report

Moon, Taehun; Chang, Won Seok; Jung, Hyun Ho; Chang, Jin Woo

Case report

Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2015;11(2):124-127.
Published online September 30, 2015.

Multicolumn Spinal Cord Stimulation for Solitary Perineal Pain : A Case Report

Taehun Moon, Won Seok Chang, Hyun Ho Jung, Jin Woo Chang

Division of Stereotactic and Functional Neurosurgery, Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

Abstract

Pudendal neuralgia is a chronic, disabling form of perineal pain. Although the effect of stimulation on neuropathic pain is well documented, the ideal management for pudendal neuralgia is not yet defined. We present a case of successful pain modulation using a multicolumn electrode to stimulate the dorsal column of a patient with medical refractory solitary perineal pain. The patient had received several surgical treatments for chronic and radiating pain in the lumbar area, as well as suffered from a severe disability because of perineal pain that worsened on sitting. A trial electrode insertion at the T12 level was performed using a multicolumn electrode, and the responses were blindly tested for a week. Stimulation resulted in a significant reduction in the patient's pain, thus dropping the numeric rating scale (NRS-11) from 8 to 3 and lengthening his sitting time and improving his quality of life. Spinal cord stimulation using a multicolumn electrode may be a viable treatment option for patients with medical refractory solitary perineal pain.

Key Words: Spinal cord stimulation, Perineal pain.