title: Peripheral field stimulation for thoracic post herpetic neuropathic pain.
abstract: OBJECTIVE
  Post herpetic neuralgia is a chronic, debilitating pain with very few management options and is often refractory to treatment. We present our experience with a series of 4 patients who underwent subcutaneous peripheral field stimulation for treatment of thoracic post herpetic neuropathic pain.
  
  
  METHODS
  Four patients with intractable thoracic post herpetic neuropathic pain were operated after maximum medical treatment and a neuropsychological evaluation. Multiple percutaneous electrodes were placed in the subcutaneous plane in the region of pain for a 7-day trial. Following a successful trial (more than 50% reduction of pain), the electrodes were then internalized and attached to a pulse generator. Visual analog scores (VAS) were studied during the preoperative, immediate postoperative and last follow-up visits. Long-term treatment results were determined by retrospective review of medical records. Average follow-up period was 28.2 months.
  
  
  RESULTS
  All 4 patients showed persistent improvement in their VAS pain scores with an average improvement of more than 75%. There were no treatment failures and no complication requiring re-operation was reported.
  
  
  CONCLUSIONS
  Peripheral field stimulation for the treatment of post herpetic neuropathic pain is a safe and effective method for pain relief for an extremely complex problem with very few solutions. Patient selection and proper lead placement is most important for the success of treatment.
authors.affiliation: Department of Neurosurgery, Center of Neuromodulation, Wexner Medical Center, The Ohio State University, Columbus, USA.
authors.forename: Zion
authors.initials: Z
authors.lastname: Zibly
authors.affiliation: Department of Neurosurgery, Center of Neuromodulation, Wexner Medical Center, The Ohio State University, Columbus, USA.
authors.forename: Mayur
authors.initials: M
authors.lastname: Sharma
authors.affiliation: Department of Neurosurgery, Center of Neuromodulation, Wexner Medical Center, The Ohio State University, Columbus, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Shaw
authors.affiliation: Department of Neurosurgery, Center of Neuromodulation, Wexner Medical Center, The Ohio State University, Columbus, USA. Electronic address: Milind.Deogaonkar@osumc.edu.
authors.forename: Milind
authors.initials: M
authors.lastname: Deogaonkar
mesh_terms: D000328:Adult; D000368:Aged; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D051474:Neuralgia, Postherpetic / Q000628:therapy*; D010147:Pain Measurement; D010148:Intractable Pain / Q000628:therapy; D018579:Patient Selection; D010525:Peripheral Nerves; D016896:Treatment Outcome
keywords: Neuromodulation; Neuropathic pain; Peripheral field stimulation; Post-herpetic; Thoracic