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What are the Risks and Benefits of Spinal Cord Stimulators and Intrathecal Pumps?

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Abstract

A 56-year-old male is evaluated during a scheduled follow-up appointment in the pain clinic for back and radicular pain that persists after an L3-5 laminectomy 2 years ago. His analgesic regimen is oxycodone controlled release, 60 mg BID (twice a day), with oxycodone immediate release, 15 mg TID (3 times a day), as needed, along with gabapentin, amitriptyline, and lidocaine patches. The patient is not satisfied with this regimen, because his pain prevents him from returning to work. He asks to have the dose of controlled release oxycodone increased because its efficacy has decreased over time. Lumbar epidural steroid injections and medial branch nerve blocks have not helped. Physical therapy offers only minimal pain relief. The patient consults with a psychiatrist for mild depression. After a recent consultation, he was offered a revision procedure by an orthopedic spine surgeon, but the patient is reluctant to accept, given the poor outcome from the first surgical intervention. The resident evaluating the patient is unsure of the next step: increase opioids? Repeat surgery? Other treatment options?

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Author information

Authors and Affiliations

  1. Department of Anesthesia and Critical Care, University of Chicago Medicine, 4851 S. Maryland Ave, MC 4028, Chicago, Illinois, 60637, USA

    Magdalena Anitescu

  2. Department of Anesthesia and Critical Care, The University of Chicago Medical Center, 5840 S. Maryland Ave, MC4028, Chicago, Illinois, 60637, USA

    Nirali Shah-Doshi

Authors
  1. Magdalena Anitescu
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  2. Nirali Shah-Doshi
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Corresponding author

Correspondence to Magdalena Anitescu .

Editor information

Editors and Affiliations

  1. Clinical Professor of Anesthesiology, Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University School of Medicine, New York, New York, USA

    Corey S. Scher

  2. Assistant Professor, Department of Anesthesia and Critical Care, The University of Chicago, Chicago, Illinois, USA

    Anna Clebone

  3. Clinical Professor of Anesthesiology (Emeritus), Former Assistant Director of Anesthesiology, Bellevue Hospital Center Retired from Department of Anesthesiology, Bellevue Hospital Center, New York University School of Medicine, New York, New York, USA

    Sanford M. Miller

  4. Clinical Associate Professor of Anesthesiology and Surgery, Bellevue Hospital Center, Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University School of Medicine, Surgical Intensive Care Unit, New York, New York, USA

    J. David Roccaforte

  5. Department of Anesthesiology, Perioperative Care and Pain Medicine, Vice Chair Faculty Promotion Associate Director Anesthesia Service Bellevue Hospital Center, New York, New York, USA

    Levon M. Capan

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© 2017 Springer International Publishing Switzerland

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Anitescu, M., Shah-Doshi, N. (2017). What are the Risks and Benefits of Spinal Cord Stimulators and Intrathecal Pumps?. In: Scher, C., Clebone, A., Miller, S., Roccaforte, J., Capan, L. (eds) You’re Wrong, I’m Right. Springer, Cham. https://doi.org/10.1007/978-3-319-43169-7_104

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  • DOI: https://doi.org/10.1007/978-3-319-43169-7_104

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43167-3

  • Online ISBN: 978-3-319-43169-7

  • eBook Packages: MedicineMedicine (R0)

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