Targeted dorsal root entry zone stimulation alleviates pain due to meralgia paresthetica.

Details

Serval ID
serval:BIB_875AD51CA7AB
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Targeted dorsal root entry zone stimulation alleviates pain due to meralgia paresthetica.
Journal
Journal of neural engineering
Author(s)
Aureli V., Vat M., Hankov N., Théaudin M., Ravier J., Becce F., Demesmaeker R., Asboth L., Courtine G., Bloch J.
ISSN
1741-2552 (Electronic)
ISSN-L
1741-2552
Publication state
Published
Issued date
07/12/2022
Peer-reviewed
Oui
Volume
19
Number
6
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Objective.Meralgia paresthetica (MP) is a mononeuropathy of the exclusively sensory lateral femoral cutaneous nerve (LFCN) that is difficult to treat with conservative treatments. Afferents from the LFCN enter the spinal cord through the dorsal root entry zones (DREZs) innervating L2 and L3 spinal segments. We previously showed that epidural electrical stimulation of the spinal cord can be configured to steer electrical currents laterally in order to target afferents within individual DREZs. Therefore, we hypothesized that this neuromodulation strategy is suitable to target the L2 and L3 DREZs that convey afferents from the painful territory, and thus alleviates MP related pain.Approach.A patient in her mid-30s presented with a four year history of dysesthesia and burning pain in the anterolateral aspect of the left thigh due to MP that was refractory to medical treatments. We combined neuroimaging and intraoperative neuromonitoring to guide the surgical placement of a paddle lead over the left DREZs innervating L2 and L3 spinal segments.Main results.Optimized electrode configurations targeting the left L2 and L3 DREZs mediated immediate and sustained alleviation of pain. The patient ceased all other medical management, reported improved quality of life, and resumed recreational physical activities.Significance.We introduced a new treatment option to alleviate pain due to MP, and demonstrated how neuromodulation strategies targeting specific DREZs is effective to reduce pain confined to specific regions of the body while avoiding disconfort.
Keywords
Humans, Female, Femoral Neuropathy, Quality of Life, Nerve Compression Syndromes/complications, Nerve Compression Syndromes/diagnosis, Nerve Compression Syndromes/therapy, Pain, Spinal Nerve Roots, dorsal root entry zone, meralgia paresthetica, neuromodulation, spinal cord stimulation
Pubmed
Web of science
Create date
04/01/2023 11:10
Last modification date
09/11/2024 11:29
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