title: Spinal cord stimulation for visceral pain--a novel approach.
abstract: BACKGROUND
  Spinal cord stimulation and dorsal column stimulation have been used successfully in the management of visceral pain for many years. A novel technique of ventral column stimulation has been used in our institute with good outcomes since 2007. We describe a retrospective series of 26 patients with visceral neuropathic pain who were treated with neuromodulation.
  
  
  METHODS
  Patients with either dermatomal hyperalgesia or sympathetically mediated neuropathic abdominal pain who had been treated with spinal cord stimulation were assessed. An independent observer conducted a face-to-face interview with each patient to collect data including demography, electrode placement, electrode mapping, and outcomes.
  
  
  RESULTS
  There was significant reduction in visual analog pain scores from a median 9 at baseline to 4 at 26 months (p ≤ 0.05). Reduction in opioid consumption was very significant from a baseline median oral morphine equivalent of 160 mg to 26 mg (p < 0.001). In addition, quality of life, activities of daily living, and patient global impression of change improved.
  
  
  CONCLUSIONS
  There is a need to further investigate the use of ventral stimulation for visceral pain syndromes. This would need multicenter trials to collect adequate numbers of patients to allow hypothesis testing to underpin recommendations for future evidence-based therapies.
authors.affiliation: Leeds Pain and Neuromodulation Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors.forename: Ganesan
authors.initials: G
authors.lastname: Baranidharan
authors.forename: Karen H
authors.initials: KH
authors.lastname: Simpson
authors.forename: Karthikeyan
authors.initials: K
authors.lastname: Dhandapani
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000494:pharmacology; D001340:Autonomic Nerve Block / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012867:Skin / Q000294:innervation; D066148:Spinal Cord Dorsal Horn / Q000502:physiology; D062187:Spinal Cord Stimulation / Q000379:methods*; D066151:Spinal Cord Ventral Horn / Q000502:physiology; D013997:Time Factors; D059265:Visceral Pain / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*
chemical_list: D000701:Analgesics, Opioid
keywords: Abdominal pain; spinal column stimulation; ventral column stimulation; visceral pain