Multicolumn Spinal Cord Stimulation for Solitary Perineal Pain : A Case Report

Abstract

Pudendal neuralgia is a chronic, disabling form of perineal pain. Although the effect of stimulation on neuropathic pain is well documented, the ideal management for pudendal neuralgia is not yet defined. We present a case of successful pain modulation using a multicolumn electrode to stimulate the dorsal column of a patient with medical refractory solitary perineal pain. The patient had received several surgical treatments for chronic and radiating pain in the lumbar area, as well as suffered from a severe disability because of perineal pain that worsened on sitting. A trial electrode insertion at the T12 level was performed using a multicolumn electrode, and the responses were blindly tested for a week. Stimulation resulted in a significant reduction in the patient’s pain, thus dropping the numeric rating scale (NRS-11) from 8 to 3 and lengthening his sitting time and improving his quality of life. Spinal cord stimulation using a multicolumn electrode may be a viable treatment option for patients with medical refractory solitary perineal pain.