PMC9981231_01
A: Schematic diagram shows the locations of pain as a gray color. The degree of pain is 6 in the left arm and 7 in the left leg assessed using a visual analog scale. B, C: Magnetic resonance images show a hemorrhagic scar at the right dorsal thalamus (B: T2-weighted, C: T2*-weighted).
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Then, the sensory disturbances changed to severe pain with allodynia of the palm and sole (Fig. 1A). Magnetic resonance imaging showed a hemorrhagic scar at the right dorsal thalamus, and the pain was diagnosed as CPSP (Fig. 1B, C).
A, B: Two percutaneous eight-contact leads are located at the Th 9-11 levels at the first spinal cord stimulation trial (A: anterior-posterior view, B: lateral view). C, D: Two plugs are inserted to lead connection holes of an implantable pulse generator for future use (arrowhead: plugs).
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Therefore, two percutaneous eight-contact leads were inserted at the Th 9-11 levels confirming the paresthesia by intraoperative stimulation, and an SCS trial was performed for 1 week (Linea ST lead 50 cm; Boston Scientific) (Fig. 2A, B). Alpha 32; Boston Scientific) on general anesthesia referring to the previous X-ray of trial leads placing. At that time, two plugs were inserted to lead connection holes of the IPG for future use (Fig. 2C, D).
A, B: Two additional percutaneous eight-contact leads are implanted at the C 3-5 levels (A: anterior-posterior view, B: lateral view).
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Because the patient demanded alleviation of the left arm pain, two additional eight-contact leads were implanted at the C 3-5 levels on general anesthesia without intraoperative stimulation (Linear ST lead 70 cm; Boston Scientific) (Fig. 3A, B).