Treatment of Ulnar Neuropathic Pain with Peripheral Nerve Stimulation: Two Case Reports

Abstract

Ulnar neuropathy is a condition that manifests with symptoms of neuropathic pain, numbness, tingling, and even possible motor deficits in the ulnar distribution of the arm. This debilitating painful condition may be refractory to conservative, pharmacologic, and surgical interventions. Peripheral nerve stimulation (PNS) technology has advanced significantly in recent years allowing for conditions such as ulnar neuropathy to be treated in a minimally invasive manner. Here we report the first case reports in the literature (to our knowledge) of two patients with intractable ulnar neuropathy who underwent minimally invasive PNS Bioventus implants. Both patients experienced at least 75% pain relief based on NRS scores at 6 months after ulnar nerve PNS implantation. The patients also experienced significant improvement in functional outcomes, including return to employment, ability to perform activities of daily living without any impairment, and improved quality of life measures. While the results presented in our two case reports are promising, we only provide observational data over a 6 to 15-month period post-implantation. Future well-powered, large-scale, and long-term randomized controlled trials are warranted to determine efficacy and long-term pain and functional outcomes from PNS therapy for treatment of ulnar neuropathy.

Keywords: Implant; Neuropathy; Peripheral Nerve Stimulation; Ulnar Nerve; Upper Extremity.