title: Coblation of Femoral and Sciatic Nerve for Stump Pain and Phantom Limb Pain: A Case Report.
abstract: BACKGROUND
  There is currently no reliable treatment for stump pain and phantom limb pain. Peripheral factors play a significant role in the pathophysiology of stump pain and phantom limb pain. Coblation technology is a relatively new technology that has shown promise in treating neuropathic pain.
  
  
  METHODS
  This report describes the use of coblation technology on femoral and sciatic nerve for stump pain and phantom limb pain. An ultrasound-guided perineural infiltration anesthesia surrounding the neuroma was first performed and achieved approximately 60% stump pain relief that lasted for 2 hours, but no relief of the phantom limb pain. An ultrasound-guided femoral and sciatic nerve block was performed to obtain longer pain relief. The patient reported approximately 80% pain relief in both stump pain and phantom limb pain that lasted for 40 hours. This finding suggested other factors in addition to the ultrasound-detected neuroma in the residual limb generating pain for this patient. Coblation of femoral and sciatic nerves was performed. The stump pain was completely relieved immediately after operation. At 1, 3, and 6 months postoperative review, 80% relief of both stump and phantom limb pain was achieved. Overall activity was improved and there was no need for pain medications. The analgesic effect was stable during the 6-month follow-up period.
  
  
  CONCLUSIONS
  Our report suggests that coblation technology may be useful treatment for stump pain and phantom limb pain. Treatments focusing on peripheral nerves may be more effective than those focusing on the neuroma. This finding needs additional study for confirmation.
authors.affiliation: Department of Pain Management, Xuanwu Hospital of Capital Medical University, Beijing, China.
authors.forename: Yuanjie
authors.initials: Y
authors.lastname: Zeng
authors.affiliation: Department of Pain Management, Xuanwu Hospital of Capital Medical University, Beijing, China.
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Pain Management, Xuanwu Hospital of Capital Medical University, Beijing, China.
authors.forename: Yuna
authors.initials: Y
authors.lastname: Guo
authors.affiliation: Department of Pain Management, Xuanwu Hospital of Capital Medical University, Beijing, China.
authors.forename: Liangliang
authors.initials: L
authors.lastname: He
authors.affiliation: Department of Pain Management, Xuanwu Hospital of Capital Medical University, Beijing, China.
authors.forename: Jiaxiang
authors.initials: J
authors.lastname: Ni
mesh_terms: D000672:Amputation Stumps / Q000473:pathology* / Q000528:radiation effects; D017115:Catheter Ablation / Q000379:methods*; D005267:Femoral Nerve / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000150:complications / Q000601:surgery; D009463:Neuroma / Q000150:complications / Q000601:surgery*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010591:Phantom Limb / Q000601:surgery*; D012584:Sciatic Nerve / Q000601:surgery
keywords: amputation; coblation; phantom limb pain; stump pain