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Subcutaneous Neuromodulating Implant Targeted at the Site of Pain
  1. Teodor Goroszeniuk, R.C.S.I., D.A. F.C.A.,
  2. Sandesha Kothari, D.N.B., D.A. F.R.C.A. and
  3. Wolfgang Hamann, Ph.D., M.D.
  1. From the Pain Management Center, St. Thomas’ and Guys Hospital, London SE1 7EH, United Kingdom.
  1. Reprint requests: Sandesha Kothari, Pain Management Centre, St. Thomas’ Hospital, London SE1 7EH, United Kingdom. E-mail: sandesha.kothari{at}


Introduction: Primary afferent stimulation for the control of chronic pain frequently offers the optimal compromise for the control of intractable pain. We describe a new access route directly to the site of pain (target) in the form of subcutaneous targeted neurostimulation (STN) via a percutaneous permanent neurostimulating implant.

Case Report: We present 3 cases with chronic intractable pain where STN via a permanent neurostimulating implant was introduced successfully. STN for 1-2 hours daily produced pain relief lasting between 12 to 24 hours, which argues that subcutaneous neurostimulation instead of stimulation of peripheral nerves is sufficient in selected cases. The effects of subcutaneous stimulation do not correlate with transcutaneous electrical nerve stimulation applied externally over the same area.

Conclusion: The introduction of an STN directly to painful areas, therefore bypassing the spinal cord and peripheral nerves, is a novel and simple procedure that is effective, in this small series, for control of intractable pain consistent with neuropathic pain.

  • Chronic intractable pain
  • Neuromodulation
  • nonsegmental neuropathic pain
  • Peripheral subcutaneous implant
  • Subcutaneous targeted neuromodulation (STN)

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  • Presented in part at the 6th World Congress of International Neuromodulation Society, Madrid, Spain, June 25-28, 2003.