Skip to main content

Advertisement

SpringerLink
Log in

Peripheral nerve field stimulation for chronic neuropathic pain: a single institution experience

  • Clinical Article - Functional
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Background

Peripheral nerve field stimulation (PNFS) is a novel neurosurgical procedure consisting of implantation of subcutaneous leads in specific painful areas in different types of painful, drug-resistant syndromes. The objective of this study was to evaluate the efficacy of PNFS in several patients affected by different chronic neuropathic pain syndromes, along with its risks, limits and possible correlation between the results achieved and the patients’ main symptoms.

Methods

Twenty-two patients affected by different types of chronic neuropathic pain were submitted to PNFS at the Department of Neurosurgery of the Istituto Neurologico “C. Besta” in Milan between July 2009 and July 2013. The visual analog scale (VAS) and variations in the use of analgesic drugs, along with complications, were considered to assess results.

Results

In 59 % of our patients, an average pain reduction of 5.50 points on the visual analog scale was observed (average pre-implant score 8.86 and average post-implant score 3.36). These patients reduced their analgesic drug use after PNFS. We observed no early or long-term complications after our last follow-up evaluation.

Conclusions

PNFS can be considered an effective and safe option to treat carefully selected, drug-resistant and chronic neuropathic pain patients; the reversibility of the procedure and its lack, at least in our hands, of long-term complications may contribute to wider use of this procedure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Deer TR (2011) Atlas of Implantable Therapies for Pain Management, 1st ed. 10.1007/978-0-387-88567-4

  2. Deogaonkar M, Slavin KV (2014) Peripheral nerve/field stimulation for neuropathic pain. Neurosurg Clin N Am 25(1):1–10

    Article  PubMed  Google Scholar 

  3. Dones I, Messina G, Franzini A (2011) A simple and safe system for avoiding electrode dislodgement in patients undergoing peripheral nerve field stimulation for chronic pain. Acta Neurochir (Wien) 153(8):1721–1722

    Article  Google Scholar 

  4. Dworkin RH, Backonja M, Rowbotham MC, Allen RR, Argoff CR, Bennett GJ, Bushnell MC, Farrar JT, Galer BS, Haythornthwaite JA, Hewitt DJ, Loeser JD, Max MB, Saltarelli M, Schmader KE, Stein C, Thompson D, Turk DC, Wallace MS, Watkins LR, Weinstein SM (2003) Advances in neuropathic pain: diagnosis, mechanisms, and treatment recommendations. Arch Neurol 60(11):1524–1534

    Article  PubMed  Google Scholar 

  5. Ellrich J, Lamp S (2005) Peripheral nerve stimulation inhibits nociceptive processing: an electrophysiological study in healthy volunteers. Neuromodulation 8:225–232

    Article  PubMed  Google Scholar 

  6. Giller CA (2003) The neurosurgical treatment of pain. Arch Neurol 60:1537–1540

    Article  PubMed  Google Scholar 

  7. Greenberg MS (2010) Handbook of Neurosurgery. Thieme, Tampa, Florida

  8. Huntoon M (2011) Peripheral nerve field stimulation versus peripheral nerve stimulation: what is the approach? Reg Anesth Pain Med 36(Suppl 2), E43

    Google Scholar 

  9. Kloimstein H, Likar R, Kern M, Neuhold J, Cada M, Loinig N, Ilias W, Freundl B, Binder H, Wolf A, Dorn C, Mozes-Balla EM, Stein R, Lappe I, Sator-Katzenschlager S (2014) Peripheral nerve field stimulation (PNFS) in chronic low back pain: a prospective multicenter study. Neuromodulation 17(2):180–187

    Article  PubMed  Google Scholar 

  10. Krames ES, Peckham PH, Rezai AR (2009) Neuromodulation, 1st edn. Academic, London

    Google Scholar 

  11. Krutsch JP, McCeney MH, Barolat G, Al Tamimi M, Smolenski A (2008) A case report of subcutaneous peripheral nerve stimulation for the treatment of axial back pain associated with postlaminectomy syndrome. Neuromodulation 11(2):112–115

    Article  PubMed  Google Scholar 

  12. Levy RM (2011) Differentiating the leaves from the branches in the tree of neuromodulation: the state of peripheral nerve field stimulation. Neuromodulation 14(3):201–205

    Article  PubMed  Google Scholar 

  13. Lindsay KW, Bone I, Fuller G (2010) Neurology and neurosurgery illustrated. Churchill Livingstone Elsevier, p 387

  14. McRoberts WP, Wolkowitz R, Meyer DJ, Lipov E, Joshi J, Davis B, Cairns KD, Barolat G (2013) Peripheral nerve field stimulation for the management of localized chronic intractable back pain: results from a randomized controlled study. Neuromodulation 16(6):565–574

    Article  PubMed  Google Scholar 

  15. Melzack R, Wall PD (1965) Pain mechanisms: a new theory. Science 150(3699):971–979

    Article  CAS  PubMed  Google Scholar 

  16. Mironer YE, Hutcheson JK, Satterthwaite JR, LaTourette PC (2011) Prospective, two-part study of the interaction between spinal cord stimulation and peripheral nerve field stimulation in patients with low back pain: development of a new spinal-peripheral neurostimulation method. Neuromodulation 14(2):151–154

    Article  PubMed  Google Scholar 

  17. Mobbs RJ, Nair S, Blum P (2007) Peripheral nerve stimulation for the treatment of chronic pain. J Clin Neurosci 14(3):216–221

    Article  CAS  PubMed  Google Scholar 

  18. Slavin KV (2008) Peripheral nerve stimulation for neuropathic pain. Neurotherapeutics 5(1):100–106

    Article  PubMed  Google Scholar 

  19. Slavin KV (2011) Peripheral nerve stimulation. Karger Medical and Scientific Publishers, Chicago, pp 1–16, 70–85, 203–217

  20. Slavin KV, Al-Nafi S, Rasskazoff Y (2013) Peripheral nerve stimulation in head and face pain. In: Eljamel S, Slavin KV (eds) Neurostimulation: principles and practice. Wiley Blackwell The Atrium Southern Gate, Chichester, pp 199–209

    Google Scholar 

  21. Slavin KV, Al-Nafi S, Rasskazoff Y (2013) Peripheral nerve stimulation in pain of the body and extremities. In: Eljamel S, Slavin KV (eds) Neurostimulation: principles and practice. Wiley Blackwell The Atrium Southern Gate, Chichester, pp 210–217

    Chapter  Google Scholar 

  22. Verrills P, Vivian D, Mitchell B, Barnard A (2011) Peripheral nerve field stimulation for chronic pain: 100 cases and review of the literature. Pain Med 12(9):1395–1405

    Article  PubMed  Google Scholar 

  23. Vranken JH (2012) Elucidation of pathophysiology and treatment of neuropathic pain. Cent Nerv Syst Agents Med Chem 12(4):304–314

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Fondazione Istituto Neurologico “C. Besta”, Via Celoria 11, 20133, Milan, Italy

    A. D’Ammando, G. Messina, A. Franzini & I. Dones

Authors
  1. A. D’Ammando
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Messina
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Franzini
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. I. Dones
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to I. Dones.

Ethics declarations

Funding

No funding was received for this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

D’Ammando, A., Messina, G., Franzini, A. et al. Peripheral nerve field stimulation for chronic neuropathic pain: a single institution experience. Acta Neurochir 158, 767–772 (2016). https://doi.org/10.1007/s00701-016-2713-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-016-2713-8

Keywords

Search

Navigation