title: Subcutaneous Peripheral Nerve Field Stimulation for the Treatment of Chronic Back Pain: Patient Selection and Technical Aspects.
abstract: A wide variety of therapeutic options are available for the treatment of chronic back pain, a very common condition in Western countries with high related social and economic costs. Nevertheless, it is not always possible to achieve adequate long-term pain relief in spite of intensive analgesic therapies. Subcutaneous peripheral nerve field stimulation (sPNFS) is a newly approved neuromodulative treatment for back pain. In previously reported case series, it has provided encouraging results on long-term pain relief, improvement in quality of life, and a reduced need for analgesic drugs. Although the surgical technique is simple, there is neither consensus for patient management nor a standardized procedure for the implantation procedure. After consideration of our personal experience and the published literature, a basic recommendation has now been developed. This represents the first step toward planning prospective studies and standardization of this treatment and will permit comparison of this technique and the results with sPNFS.
authors.affiliation: Department of Neurosurgery, Diakonie Hospital Friederikenstift, Hannover, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Winkelmueller
authors.affiliation: Department of Neurosurgery, UKGM University of Giessen, Giessen, Germany.
authors.forename: Malgorzata Anna
authors.initials: MA
authors.lastname: Kolodziej
authors.affiliation: Department of Anesthesiology and Pain Unit, Hospital Iserlohn, Iserlohn, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Welke
authors.affiliation: Department of Stereotactic and Functional Neurosurgery, University of Cologne, Cologne, Germany.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Koulousakis
authors.affiliation: Department of Neurosurgery, UMG University of Goettingen, Göttingen, Germany.
authors.forename: Ramon
authors.initials: R
authors.lastname: Martinez
mesh_terms: D032921:Consensus; D004599:Electric Stimulation Therapy / Q000295:instrumentation / Q000379:methods*; D004567:Electrodes, Implanted; D006801:Humans; D017116:Low Back Pain / Q000523:psychology / Q000628:therapy*; D019635:Neurosurgical Procedures / Q000379:methods; D010147:Pain Measurement; D018579:Patient Selection; D010525:Peripheral Nerves; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome