Targeted dorsal root entry zone stimulation alleviates pain due to meralgia paresthetica.
Détails
ID Serval
serval:BIB_875AD51CA7AB
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Institution
Titre
Targeted dorsal root entry zone stimulation alleviates pain due to meralgia paresthetica.
Périodique
Journal of neural engineering
ISSN
1741-2552 (Electronic)
ISSN-L
1741-2552
Statut éditorial
Publié
Date de publication
07/12/2022
Peer-reviewed
Oui
Volume
19
Numéro
6
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Publication Status: epublish
Résumé
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.
Mots-clé
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
Création de la notice
04/01/2023 11:10
Dernière modification de la notice
09/11/2024 11:29