Peripheral Nerve Field Stimulation for Chronic Pain: 100 Cases and Review of the Literature

• Published in: Pain medicine (Malden, Mass.) Mass.), 2011-09, Vol.12 (9), p.1395-1405
• Main Authors: Verrills, Paul, Vivian, David, Mitchell, Bruce, Barnard, Adele
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Analgesics; Chronic Pain; Chronic Pain - diagnosis; Chronic Pain - physiopathology; Chronic Pain - therapy; Craniofacial Pain; Electric Stimulation Therapy - instrumentation; Electric Stimulation Therapy - methods; Female; Humans; Low Back Pain; Male; Medical research; Middle Aged; Neuromodulation; Pain management; Patient satisfaction; Patients; Peripheral Nerve Field Stimulation; Peripheral Nerves - pathology; Peripheral Nerves - physiopathology; Peripheral Nerves - surgery; Prospective Studies; Subcutaneous Lead Stimulation; Treatment Outcome; Young Adult
• ISSN: 1526-2375; 1526-4637
• DOI: 10.1111/j.1526-4637.2011.01201.x

Objective.  To evaluate the clinical outcomes of 100 consecutive patients receiving peripheral nerve field stimulation (PNFS) for the treatment of chronic intractable pain. Design.  Prospective, observational study. Setting.  A private interventional pain specialty referral practice. Patients.  One hundred consecutive private practice patients receiving PNFS for the treatment of chronic craniofacial, thorax, lumbosacral, abdominal, pelvic, and groin pain conditions. Outcome Measures.  Pain (11‐point numerical rating scale), complications, changes to analgesic use and employment status, disability (Oswestry or Neck Disability Indexes), depression (Zung Depression Index), and patient satisfaction. Results.  We demonstrate an average pain reduction of 4.2 ± 2.5 pain scale points on an 11‐point scale following PNFS (preimplant pain score of 7.4 ± 1.7 to a follow‐up average of 3.2 ± 2.3 pain scale points) (P ≤ 0.00). At a follow‐up period of 8.1 ± 4.7 months (range 1–23 months), an overall 72% of patients reduced their analgesic use following PNFS. Patients receiving a lumbosacral PNFS for chronic low back pain reported a significant reduction in disability following treatment, as determined by the Oswestry Disability Index. Of the 100 cases, no long‐term complications were reported. Conclusions.  This prospective 100 consecutive PNFS patient outcome study demonstrates that PNFS can be a safe and effective treatment option for, otherwise, intractable chronic pain conditions. PNFS has the potential to fundamentally change the way we think about pain management.