title: Spinal cord stimulation in the treatment of postherpetic neuralgia in patients with chronic kidney disease: a case series and review of the literature.
abstract: BACKGROUND
  Postherpetic neuralgia (PHN) is usually managed pharmacologically. It is not uncommon for patients with chronic kidney disease (CKD) to suffer from PHN. It is difficult to prescribe a sufficient dose of anticonvulsants for intractable pain because of the decreased glomerular filtration rate. If the neural blockade and pulsed radiofrequency ablation provide only short-term amelioration of pain, spinal cord stimulation (SCS) with a low level of evidence may be used only as a last resort. This study was done to evaluate the efficacy of spinal cord stimulation in the treatment of PHN in patients with CKD.
  
  
  METHODS
  PHN patients with CKD who needed hemo-dialysis who received insufficient relief of pain over a VAS of 8 regardless of the neuropathic medications were eligible for SCS trial. The follow-up period was at least 2 years after permanent implantation.
  
  
  RESULTS
  Eleven patients received percutaneous SCS test trial from Jan 2003 to Dec 2007. Four patients had successfully received a permanent SCS implant with their pain being tolerable at a VAS score of less than 3 along with small doses of neuropathic medications.
  
  
  CONCLUSIONS
  SCS was helpful in managing tolerable pain levels in some PHN patients with CKD along with tolerable neuropathic medications for over 2 years.
authors.affiliation: Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Busan, Korea.
authors.forename: In Yeob
authors.initials: IY
authors.lastname: Baek
authors.forename: Ju Yeon
authors.initials: JY
authors.lastname: Park
authors.forename: Hyae Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Ji Uk
authors.initials: JU
authors.lastname: Yoon
authors.forename: Gyeong Jo
authors.initials: GJ
authors.lastname: Byoen
authors.forename: Kyung Hoon
authors.initials: KH
authors.lastname: Kim