Abstract
Objectives
Patients with spinal lesions or vertebral compression fractures from multiple myeloma
often present with back pain that restricts their ability to lie flat and prevents
them from undergoing cancer treatment. Temporary, percutaneous peripheral nerve stimulation
(PNS) has been described for cancer pain secondary to oncologic surgery or neuropathy/radiculopathy
from tumor invasion. The purpose of this case series is to show the use of PNS as
an analgesic bridge therapy to treat myeloma-related back pain and allow patients
to complete their course of radiation.
Materials and Methods
Temporary, percutaneous PNS was placed under fluoroscopic guidance for four patients
with unremitting low back pain secondary to myelomatous spinal lesions. Before PNS,
the patients had pain refractory to medical management and were unable to tolerate
radiation mapping and treatment owing to low back pain while supine. Patients were
followed with routine clinic visits to monitor pain and progression through cancer
therapy. PNS was removed after approximately 60 days or after completion of radiation.
Results
This case series presents four successful cases of PNS to treat low back pain from
myelomatous spinal lesions and associated vertebral compression fractures. PNS targeted
the medial branch nerves to treat both nociceptive and neuropathic low back pain.
All four patients successfully completed radiation therapy with PNS in place.
Conclusions
PNS can effectively treat low back pain secondary to myeloma-related spinal lesions
as a bridge therapy to radiation. The use of PNS is a promising option for back pain
from other primary or metastatic tumors. Further research is needed into the use of
PNS for cancer-related back pain.
Keywords
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Comment
Article info
Publication history
Published online: March 02, 2023
Accepted:
January 30,
2023
Received in revised form:
December 23,
2022
Received:
October 11,
2022
Footnotes
Source(s) of financial support: The authors reported no funding sources.
Conflict of Interest: Grant H. Chen is a consultant for SPR Therapeutics. The remaining authors reported no conflict of interest.
Identification
Copyright
© 2023 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.
