Please confirm that an ethics committee approval has been applied for or granted: Not relevant

Background and Aims Multiple sclerosis (MS) is a central nervous system chronic disease that affects millions of people worldwide, causing motor problems, neuropathic pain, and urinary disorders. Controlling neuropathic pain in MS is particularly challenging, with conventional treatments often proving ineffective. In this case, posterior cord stimulation (PCS) was evaluated as a treatment for neuropathic pain in a 73-year-old woman with primary progressive MS and significant functional limitations.

Methods The patient, diagnosed at 62, experienced worsening neuropathic pain in 2019 without relief from conventional therapies. A percutaneous dodecapolar electrode was implanted for PCS. The initial trial resulted in significant pain reduction, leading to the permanent implantation of a subcutaneous generator.

Results The initial trial with the percutaneous dodecapolar electrode resulted in a 60-70% reduction in pain, which remained stable over time. Following the success of the trial, a permanent subcutaneous generator was implanted, maintaining a 80% pain reduction. This improvement increased the patient‘s participation in daily activities and reduced the need for analgesic medications. No exacerbations of MS were observed.

Conclusions This case suggests that PCS is a promising and safe option for managing neuropathic pain in MS, aligning with studies reporting improvements in over 50% of cases. PCS can offer significant benefits in quality of life and pain control for patients with MS refractory to conventional treatment. Neuromodulation technology continues to advance, promising new opportunities for the effective management of this condition.