Spinal cord stimulation in complex regional pain syndrome with severe epidural adhesions: A case report

Lee, Sun Yeul; Ko, Young Kwon; Kang, Young Mi; Lee, Won Hyung

Case Report

Spinal Pain

Anesthesia and Pain Medicine 2011;6(3):216-220.
Published online July 30, 2011.

Spinal cord stimulation in complex regional pain syndrome with severe epidural adhesions: A case report

Sun Yeul Lee, Young Kwon Ko, Young Mi Kang, Won Hyung Lee

Department of Anesthesiology and Pain Medicine, Chungnam National University School of Medicine, Daejeon, Korea. whlee@cnu.ac.kr

Abstract

Complex regional pain syndrome (CRPS) is often a devastating neuropathic condition that has been recognized with increasing frequency in the lower extremities. Patients with CRPS may worsen to such a degree that the individual may never return to a satisfactory and productive life. Spinal cord stimulation (SCS) is one of the most minimally invasive and effective treatments for intractable pain such as CRPS. The most important factor for successful stimulation of the spinal cord is proper lead position that stimulation and pain regions match completely. A 39-year-old male patient, suffering from CRPS type II in his lower extremity, visited our pain clinic. It was a difficult case that the electrode for spinal cord stimulation was positioned at the proper site due to the adhesion of the epidural space by frequent epidural blocks and procedures. We report the efficacy of a steerable epidural catheter for adhesiolysis on the setting the electrode to the proper site in the epidural space.

Key Words: Complex regional pain syndrome, Epidural adhesiolysis, Spinal cord stimulation