Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page)

Background and Aims Here we present a forty-five-year-old, right hand dominant male who suffered a traumatic right forearm crush injury while using a cement mixer. Following multiple orthopedic procedures and superficial radial nerve neuroma excision, he developed chronic neuropathic pain in his right forearm. He was refractory to conservative treatments and continued to experience this pain for fifteen years before being referred to our Pain Clinic. He reported that the ongoing pain affected his quality of life and hindered his occupation as a welder.

Methods His exam was consistent with a right radial nerve mononeuropathy and he was offered a temporary peripheral nerve stimulator (PNS). Ultrasound was used to identify the right radial nerve 10 cm proximal to the patient’s elbow. Local anesthetic was used to numb the desired entry site, with care taken to avoid administering local anesthetic near the target site which can obscure response to neurostimulation. Following successful test stimulation the lead was deployed. Repeat stimulation and ultrasound imaging confirmed successful placement, and following device management education, the patient was discharged.

Results The patient achieved complete resolution of his neuropathic pain during 60-day stimulation and sustained relief at one year follow-up.

• Download figure
• Open in new tab
• Download powerpoint

Abstract #36256 Figure 1

Ultrasound image of the PNS MicroLead deployed via introducer sheath 4mm from the right radial nerve

Conclusions Peripheral nerve stimulation should be considered for patients with neuropathic pain in which the target nerve can be identified. Interventional pain physicians should work to further disseminate the utility of PNS in hopes that future patients do not have to suffer for 15 years before being referred to a pain clinic.