Spinal Cord Stimulation Combined with Anterior Cingulotomy to Manage Refractory Phantom Limb Pain

Stereotact Funct Neurosurg. 2018;96(3):204-208. doi: 10.1159/000489946. Epub 2018 Jul 25.

Abstract

Background: Phantom limb pain (PLP) is an intractable and debilitating disease without satisfactory treatment options presently available. Central reorganization, peripheral changes, and psychiatric factors contribute to its development; thus, a neuropsychiatry-orientated combined therapy could be promising.

Objectives: We used a combined strategy with the aims of demonstrating its therapeutic outcomes on PLP.

Methods: The patient initially received spinal cord stimulation (SCS) implantation and then anterior cingulotomy (ACING) 2 years later. We administered the Hamilton Depression Scale-24, Hamilton Anxiety Scale, Pain Rating Index, Numerical Pain Rating Scale, and the Short Form (36) Health Survey to assess its outcomes at 5 time points, namely the time before performing SCS implantation, 1 year and 2 years after SCS implantation, and 1 year and 2 years after SCS combined with ACING.

Results: Excellent pain relief and significant improvement in depression symptoms were observed in this patient with PLP who underwent SCS combined with ACING.

Conclusions: This report suggests that SCS combined with ACING is efficacious for PLP. However, further studies are warranted.

Keywords: Anterior cingulotomy; Phantom limb pain; Psychiatric comorbidities; Spinal cord stimulation.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Humans
  • Male
  • Pain / surgery*
  • Pain Management*
  • Pain Measurement
  • Phantom Limb / surgery
  • Phantom Limb / therapy*
  • Spinal Cord Stimulation*
  • Treatment Outcome