The use of spinal cord stimulation in refractory abdominal visceral pain: case reports and literature review.
Patients will commonly seek medical attention for refractory abdominal pain. The many causes of abdominal pain include pathologies of the gastrointestinal, genitourinary, musculoskeletal, and nervous systems. Unfortunately, a large number of patients will develop chronic abdominal pain that is recalcitrant to definitive therapies and nonspecific treatments such as cognitive-behavioral, physical, and pharmacologic therapies. Although spinal cord stimulation is classically used for neuropathic and ischemic conditions, a growing number of reports describe its efficacy in visceral disease. We describe our experience with spinal cord stimulation in two patients with refractory abdominal pain. Although the exact etiology in these complex patients is not defined, it is theorized that visceral hypersensitivity is at least one component. Finally, we will summarize the applicable literature in order to explain a possible mechanism of analgesia in visceral disease.
Tiede
Jeffrey M
JM
Department of Pain Management, Mayo Clinic College of Medicine, Jacksonville, Florida 32224, USA. tiede.jeffrey@mayo.edu
Ghazi
Salim M
SM
Lamer
Tim J
TJ
Obray
Jon B
JB
D015746:Abdominal Pain / Q000628:therapy*; D000328:Adult; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D010148:Intractable Pain / Q000628:therapy*; D017060:Patient Satisfaction; D013116:Spinal Cord / Q000502:physiology*; D017833:Visceral Afferents / Q000502:physiology