Combined epidural and peripheral nerve stimulation for relief of pain. Description of technique and preliminary results.
A technique is described that combines percutaneous epidural with peripheral nerve stimulation to provide limited paresthesia to a lower extremity. The peripheral electrode is placed percutaneously and positioned along the course of the anterior division fo the spinal nerve anterolateral to the vertebral bodies. This is accomplished by a modified epidural tap. Combined stimulation was carried out in 23 patients with intractable leg pain. Sixteen patients proceeded to chronic autostimulation; follow-up time extended to 18 months. The procedure proved simple; there were no perioperative and only few minor late complications. Results were similar to those from conventional epidural stimulator implantation. It is concluded that combined epidural-peripheral nerve stimulation constitutes a valid therapeutic alternative for patients with unilateral lower extremity pain.
D000328:Adult; D000368:Aged; D001416:Back Pain / Q000628:therapy; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000379:methods; D004824:Epidural Space; D005260:Female; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010292:Paresthesia / Q000209:etiology; D010525:Peripheral Nerves