Spinal cord stimulation for cancer-related low back pain. Treatment of cancer-related chest wall pain using spinal cord stimulation.
At least one third of patients with cancer have pain at the time of their diagnosis. In an attempt to provide increased pain relief for patients with intractable cancer pain, unconventional agents and interventional procedures including spinal cord stimulation (SCS) have received considerable attention.
                Patients with cancer-related low back pain underwent an uneventful SCS trial with percutaneous placement of 2 temporary 8-electrode leads placed at the level of T8-T9-T10.
                After experiencing excellent pain relief during the 2-day trial, patients were subsequently implanted with permanent leads and generator with sustained pain relief at 12 months postoperation.
                Spinal cord stimulation provides an effective, alternative treatment option for select patients with cancer-related pain who have failed conservative treatment. it has been estimated that 15% to 40% of chronic cancer pain has a neuropathic component, and this type of pain often responds poorly to opioids. In an attempt to provide increased pain relief for patients with intractable cancer pain, unconventional agents and interventional management approaches have received considerable attention. Spinal cord stimulation (SCS) has been used with increased frequency for the treatment of intractable cancer pain.
                the patients with a history of cancer-related chest wall pain underwent an uneventful SCS trial with percutaneous placement of 2 temporary 8-electrode leads (Medtronic Inc, Minneapolis, Minnesota) placed at the level of T3-T4-T5.
                after experiencing excellent pain relief over the next 2 days, the patients were implanted with permanent leads and rechargeable generator 2 to 2 ½ weeks later and reported sustained pain relief at 12-month follow-up visit. Conclusion: SCS provides an effective, alternative treatment option for select patients with cancer-related chest wall pain who have failed conservative treatment. SCS may provide pain relief with advantages over conservative treatments and more invasive techniques.
Although there is limited evidence in favour of SCS for Failed Back Surgery Syndrome and Complex Regional Pain Syndrome Type I, more trials are needed to confirm whether SCS is an effective treatment for certain types of chronic pain. In addition, there needs to be a debate about trial designs that will provide the best evidence for assessing this type of intervention.