Wireless Peripheral Nerve Stimulation for the Treatment of Chronic Shoulder Pain

Abstract

Background: Shoulder pain is a common condition, often refractory to treatment. Peripheral nerve stimulation (PNS) of the suprascapular nerve (SSN) can be efficacious in providing relief of shoulder pain while improving pain-related quality of life (QOL). The objective of this case report is to demonstrate the effectiveness of a minimally invasive wireless PNS in the treatment of chronic shoulder pain. Case Report: This 94-year old man presented with severe shoulder pain. He suffered from poliomyelitis as a child affecting his left leg, forcing him to use crutches to be ambulatory. He developed progressive right shoulder pain and was subsequently diagnosed with right glenohumeral osteoarthritis. The patient was treated semiannually for 4 years with corticosteroids injections and pain medication with minimal relief (7 out of 10 on the Visual Analog Scale [VAS]). A suprascapular block with lidocaine 2% resulted in significant pain reduction (1 out of 10 on the VAS). As a result, the patient opted for wireless PNS of the SSN via a minimally invasive procedure. Two weeks post implant, the patient reported no postoperative pain, and his chronic pain was rated 0 out of 10 even during movement. Reports of reduced pain were sustained throughout the 6 months of observation with subsequent improvements in QOL and functionality. Conclusion: Wireless neurostimulation of the SSN can be a very effective therapy option for the treatment of refractory, chronic shoulder pain as a result of glenohumeral osteoarthritis. Key words: Endoscopic spine surgery, lumbar radiculopathy, minimally invasive spine, SI joint fusion