Spinal cord stimulation for chronic pain treatment following sacral chordoma resection: illustrative case.

Autor:	Taghlabi KM; 1Department of Neurological Surgery, Houston Methodist Hospital, Houston, Texas; and.; 2Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, Texas., Hassan T; 1Department of Neurological Surgery, Houston Methodist Hospital, Houston, Texas; and.; 2Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, Texas., Somawardana IA; 1Department of Neurological Surgery, Houston Methodist Hospital, Houston, Texas; and.; 2Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, Texas., Rajendran S; 1Department of Neurological Surgery, Houston Methodist Hospital, Houston, Texas; and.; 2Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, Texas., Doomi A; 1Department of Neurological Surgery, Houston Methodist Hospital, Houston, Texas; and., Bhenderu LS; 1Department of Neurological Surgery, Houston Methodist Hospital, Houston, Texas; and.; 2Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, Texas., Cruz-Garza JG; 1Department of Neurological Surgery, Houston Methodist Hospital, Houston, Texas; and.; 2Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, Texas., Faraji AH; 1Department of Neurological Surgery, Houston Methodist Hospital, Houston, Texas; and.; 2Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, Texas.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Case lessons [J Neurosurg Case Lessons] 2023 Dec 25; Vol. 6 (26). Date of Electronic Publication: 2023 Dec 25 (Print Publication: 2023).
DOI:	10.3171/CASE23540
Abstrakt:	Background: Cancer-related or postoperative pain can occur following sacral chordoma resection. Despite a lack of current recommendations for cancer pain treatment, spinal cord stimulation (SCS) has demonstrated effectiveness in addressing cancer-related pain. Observations: A 76-year-old female with a sacral chordoma underwent anterior osteotomies and partial en bloc sacrectomy. She subsequently presented with chronic pain affecting both buttocks and posterior thighs and legs, significantly impeding her daily activities. She underwent a staged epidural SCS paddle trial and permanent system placement using intraoperative neuromonitoring. The utilization of percutaneous leads was not viable because of her history of spinal fluid leakage, multiple lumbosacral surgeries, and previous complex plastic surgery closure. The patient reported a 62.5% improvement in her lower-extremity pain per the modified Quadruple Visual Analog Scale and a 50% improvement in the modified Pain and Sleep Questionnaire 3-item index during the SCS trial. Following permanent SCS system placement and removal of her externalized lead extenders, she had an uncomplicated postoperative course and reported notable improvements in her pain symptoms. Lessons: This case provides a compelling illustration of the successful treatment of chronic pain using SCS following radical sacral chordoma resection. Surgeons may consider this treatment approach in patients presenting with refractory pain following spinal tumor resection.
Databáze:	MEDLINE
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