Korean J Pain.  2011 Sep;24(3):154-157. 10.3344/kjp.2011.24.3.154.

Spinal Cord Stimulation in the Treatment of Postherpetic Neuralgia in Patients with Chronic Kidney Disease: A Case Series and Review of the Literature

• Baek IY
• Park JY
• Kim HJ
• Yoon JU
• Byoen GJ
• Kim KH

• KMID: 2278104
• DOI: http://doi.org/10.3344/kjp.2011.24.3.154

Abstract

BACKGROUND
Postherpetic neuralgia (PHN) is usually managed pharmacologically. It is not uncommon for patients with chronic kidney disease (CKD) to suffer from PHN. It is difficult to prescribe a sufficient dose of anticonvulsants for intractable pain because of the decreased glomerular filtration rate. If the neural blockade and pulsed radiofrequency ablation provide only short-term amelioration of pain, spinal cord stimulation (SCS) with a low level of evidence may be used only as a last resort. This study was done to evaluate the efficacy of spinal cord stimulation in the treatment of PHN in patients with CKD.
METHODS
PHN patients with CKD who needed hemo-dialysis who received insufficient relief of pain over a VAS of 8 regardless of the neuropathic medications were eligible for SCS trial. The follow-up period was at least 2 years after permanent implantation.
RESULTS
Eleven patients received percutaneous SCS test trial from Jan 2003 to Dec 2007. Four patients had successfully received a permanent SCS implant with their pain being tolerable at a VAS score of less than 3 along with small doses of neuropathic medications.
CONCLUSIONS
SCS was helpful in managing tolerable pain levels in some PHN patients with CKD along with tolerable neuropathic medications for over 2 years.

Keyword

anticonvulsants; kidney disease; postherpetic neuralgia; spinal cord; therapeutic electric stimulation

MeSH Terms

Anticonvulsants
Electric Stimulation Therapy
Follow-Up Studies
Glomerular Filtration Rate
Health Resorts
Humans
Kidney
Kidney Diseases
Neuralgia, Postherpetic
Pain, Intractable
Renal Insufficiency, Chronic
Spinal Cord
Spinal Cord Stimulation
Anticonvulsants

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