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Spinal cord stimulation for chronic pain treatment following sacral chordoma resection: illustrative case
Cancer-related or postoperative pain can occur following sacral chordoma resection. Despite a lack of current recommendations for cancer pain treatment, spinal cord stimulation (SCS) has demonstrated effectiveness in addressing cancer-related pain. A 76-year-old female with a sacral chordoma underwe...
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Published in: | Journal of neurosurgery. Case lessons 2023-12, Vol.6 (26) |
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container_title | Journal of neurosurgery. Case lessons |
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creator | Taghlabi, Khaled M Hassan, Taimur Somawardana, Isuru A Rajendran, Sibi Doomi, Ahmed Bhenderu, Lokeshwar S Cruz-Garza, Jesus G Faraji, Amir H |
description | Cancer-related or postoperative pain can occur following sacral chordoma resection. Despite a lack of current recommendations for cancer pain treatment, spinal cord stimulation (SCS) has demonstrated effectiveness in addressing cancer-related pain.
A 76-year-old female with a sacral chordoma underwent anterior osteotomies and partial en bloc sacrectomy. She subsequently presented with chronic pain affecting both buttocks and posterior thighs and legs, significantly impeding her daily activities. She underwent a staged epidural SCS paddle trial and permanent system placement using intraoperative neuromonitoring. The utilization of percutaneous leads was not viable because of her history of spinal fluid leakage, multiple lumbosacral surgeries, and previous complex plastic surgery closure. The patient reported a 62.5% improvement in her lower-extremity pain per the modified Quadruple Visual Analog Scale and a 50% improvement in the modified Pain and Sleep Questionnaire 3-item index during the SCS trial. Following permanent SCS system placement and removal of her externalized lead extenders, she had an uncomplicated postoperative course and reported notable improvements in her pain symptoms.
This case provides a compelling illustration of the successful treatment of chronic pain using SCS following radical sacral chordoma resection. Surgeons may consider this treatment approach in patients presenting with refractory pain following spinal tumor resection. |
doi_str_mv | 10.3171/CASE23540 |
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A 76-year-old female with a sacral chordoma underwent anterior osteotomies and partial en bloc sacrectomy. She subsequently presented with chronic pain affecting both buttocks and posterior thighs and legs, significantly impeding her daily activities. She underwent a staged epidural SCS paddle trial and permanent system placement using intraoperative neuromonitoring. The utilization of percutaneous leads was not viable because of her history of spinal fluid leakage, multiple lumbosacral surgeries, and previous complex plastic surgery closure. The patient reported a 62.5% improvement in her lower-extremity pain per the modified Quadruple Visual Analog Scale and a 50% improvement in the modified Pain and Sleep Questionnaire 3-item index during the SCS trial. Following permanent SCS system placement and removal of her externalized lead extenders, she had an uncomplicated postoperative course and reported notable improvements in her pain symptoms.
This case provides a compelling illustration of the successful treatment of chronic pain using SCS following radical sacral chordoma resection. Surgeons may consider this treatment approach in patients presenting with refractory pain following spinal tumor resection.</description><identifier>ISSN: 2694-1902</identifier><identifier>EISSN: 2694-1902</identifier><identifier>DOI: 10.3171/CASE23540</identifier><identifier>PMID: 38145561</identifier><language>eng</language><publisher>United States: American Association of Neurological Surgeons</publisher><subject>Case Lesson</subject><ispartof>Journal of neurosurgery. Case lessons, 2023-12, Vol.6 (26)</ispartof><rights>2023 The authors 2023</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10751222/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10751222/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38145561$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Taghlabi, Khaled M</creatorcontrib><creatorcontrib>Hassan, Taimur</creatorcontrib><creatorcontrib>Somawardana, Isuru A</creatorcontrib><creatorcontrib>Rajendran, Sibi</creatorcontrib><creatorcontrib>Doomi, Ahmed</creatorcontrib><creatorcontrib>Bhenderu, Lokeshwar S</creatorcontrib><creatorcontrib>Cruz-Garza, Jesus G</creatorcontrib><creatorcontrib>Faraji, Amir H</creatorcontrib><title>Spinal cord stimulation for chronic pain treatment following sacral chordoma resection: illustrative case</title><title>Journal of neurosurgery. Case lessons</title><addtitle>J Neurosurg Case Lessons</addtitle><description>Cancer-related or postoperative pain can occur following sacral chordoma resection. Despite a lack of current recommendations for cancer pain treatment, spinal cord stimulation (SCS) has demonstrated effectiveness in addressing cancer-related pain.
A 76-year-old female with a sacral chordoma underwent anterior osteotomies and partial en bloc sacrectomy. She subsequently presented with chronic pain affecting both buttocks and posterior thighs and legs, significantly impeding her daily activities. She underwent a staged epidural SCS paddle trial and permanent system placement using intraoperative neuromonitoring. The utilization of percutaneous leads was not viable because of her history of spinal fluid leakage, multiple lumbosacral surgeries, and previous complex plastic surgery closure. The patient reported a 62.5% improvement in her lower-extremity pain per the modified Quadruple Visual Analog Scale and a 50% improvement in the modified Pain and Sleep Questionnaire 3-item index during the SCS trial. Following permanent SCS system placement and removal of her externalized lead extenders, she had an uncomplicated postoperative course and reported notable improvements in her pain symptoms.
This case provides a compelling illustration of the successful treatment of chronic pain using SCS following radical sacral chordoma resection. Surgeons may consider this treatment approach in patients presenting with refractory pain following spinal tumor resection.</description><subject>Case Lesson</subject><issn>2694-1902</issn><issn>2694-1902</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNpVkUtPAyEUhYnR2KZ24R8wLHUxCsyDGTfGNPWRNHFRXRPKXFoMM1SYqfHfS9Pa1BUk9zuHczkIXVJym1JO7yaP8ylL84ycoCErqiyhFWGnR_cBGofwSQhhFWMpYedokJY0y_OCDpGZr00rLVbO1zh0pumt7IxrsXYeq5V3rVF4LU2LOw-ya6Dt4sha923aJQ5S-a14FdWukdhDALWV32NjbR86H802gJUMcIHOtLQBxvtzhD6epu-Tl2T29vw6eZwliuWUJJozqThAvsjrVDPISg6U1iQtSi11nfFSQq2zSkNVyZKzgkWI6wzqmui4cjpCDzvfdb9ooFYxccwo1t400v8IJ434P2nNSizdRlDCc8riF43Q9d7Bu68eQicaExRYK1twfRCsIgXlFeUkojc7VHkXggd9eIcSsa1HHOqJ7NVxsAP5V0b6CxAUjec</recordid><startdate>20231225</startdate><enddate>20231225</enddate><creator>Taghlabi, Khaled M</creator><creator>Hassan, Taimur</creator><creator>Somawardana, Isuru A</creator><creator>Rajendran, Sibi</creator><creator>Doomi, Ahmed</creator><creator>Bhenderu, Lokeshwar S</creator><creator>Cruz-Garza, Jesus G</creator><creator>Faraji, Amir H</creator><general>American Association of Neurological Surgeons</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20231225</creationdate><title>Spinal cord stimulation for chronic pain treatment following sacral chordoma resection: illustrative case</title><author>Taghlabi, Khaled M ; Hassan, Taimur ; Somawardana, Isuru A ; Rajendran, Sibi ; Doomi, Ahmed ; Bhenderu, Lokeshwar S ; Cruz-Garza, Jesus G ; Faraji, Amir H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2510-f72ac7ee5b5d3f2e487e11d0368fafd478aedf49fe99a87262f2e7f4edd0f6943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Case Lesson</topic><toplevel>online_resources</toplevel><creatorcontrib>Taghlabi, Khaled M</creatorcontrib><creatorcontrib>Hassan, Taimur</creatorcontrib><creatorcontrib>Somawardana, Isuru A</creatorcontrib><creatorcontrib>Rajendran, Sibi</creatorcontrib><creatorcontrib>Doomi, Ahmed</creatorcontrib><creatorcontrib>Bhenderu, Lokeshwar S</creatorcontrib><creatorcontrib>Cruz-Garza, Jesus G</creatorcontrib><creatorcontrib>Faraji, Amir H</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of neurosurgery. Case lessons</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Taghlabi, Khaled M</au><au>Hassan, Taimur</au><au>Somawardana, Isuru A</au><au>Rajendran, Sibi</au><au>Doomi, Ahmed</au><au>Bhenderu, Lokeshwar S</au><au>Cruz-Garza, Jesus G</au><au>Faraji, Amir H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Spinal cord stimulation for chronic pain treatment following sacral chordoma resection: illustrative case</atitle><jtitle>Journal of neurosurgery. Case lessons</jtitle><addtitle>J Neurosurg Case Lessons</addtitle><date>2023-12-25</date><risdate>2023</risdate><volume>6</volume><issue>26</issue><issn>2694-1902</issn><eissn>2694-1902</eissn><abstract>Cancer-related or postoperative pain can occur following sacral chordoma resection. Despite a lack of current recommendations for cancer pain treatment, spinal cord stimulation (SCS) has demonstrated effectiveness in addressing cancer-related pain.
A 76-year-old female with a sacral chordoma underwent anterior osteotomies and partial en bloc sacrectomy. She subsequently presented with chronic pain affecting both buttocks and posterior thighs and legs, significantly impeding her daily activities. She underwent a staged epidural SCS paddle trial and permanent system placement using intraoperative neuromonitoring. The utilization of percutaneous leads was not viable because of her history of spinal fluid leakage, multiple lumbosacral surgeries, and previous complex plastic surgery closure. The patient reported a 62.5% improvement in her lower-extremity pain per the modified Quadruple Visual Analog Scale and a 50% improvement in the modified Pain and Sleep Questionnaire 3-item index during the SCS trial. Following permanent SCS system placement and removal of her externalized lead extenders, she had an uncomplicated postoperative course and reported notable improvements in her pain symptoms.
This case provides a compelling illustration of the successful treatment of chronic pain using SCS following radical sacral chordoma resection. Surgeons may consider this treatment approach in patients presenting with refractory pain following spinal tumor resection.</abstract><cop>United States</cop><pub>American Association of Neurological Surgeons</pub><pmid>38145561</pmid><doi>10.3171/CASE23540</doi><oa>free_for_read</oa></addata></record> |
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subjects | Case Lesson |
title | Spinal cord stimulation for chronic pain treatment following sacral chordoma resection: illustrative case |
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