Present treatment methods are often unsatisfactory in reducing post-
amputation pain. Peripheral nerve stimulation (PNS) could reduce the
pain, but it is rarely used because present methods require invasive surgical access and precise placement of the leads in close proximity (≤ 2 mm) with the nerve.
METHODS: Fourteen of the 16 subjects who completed in-clinic testing responded to stimulation, reported ≥ 75%
paresthesia coverage, obtained clinically significant
pain relief, and proceeded to a two-week home trial with a percutaneous PNS system. Two of the 14 responders had their leads removed early because of accidental dislodgement (N = 2), two had temporary discomfort near the lead (N = 2), and one had return of post-
amputation pain despite stimulation (N = 1) and did not complete the home trial. The nine responders who completed the home trial reported reductions in their mean daily worst post-
amputation pain (56 ± 26%, 56 ± 26%, N = 9), average residual limb
pain (72 ± 28%, 42 ± 27%, N = 7), average
phantom limb pain (81 ± 28%, 47 ± 48%, N = 7), residual limb
pain interference (81 ± 27%, 53 ± 17%, N = 6),
phantom limb pain interference (83 ± 31%, 56 ± 46%, N = 7), and
Pain Disability Index (70 ± 38%, 55 ± 32%, N = 9) during the second week of stimulation and four weeks after the end of stimulation, respectively. All nine responders rated their change in quality of life as improved at the end of stimulation and at the end of the four-week follow-up period. Subjects reported minor decreases in the Beck Depression Inventory scores (43 ± 51%, 32 ± 57%, N = 9). Most subjects had no substantial changes other than minor decreases (N = 3) in
pain medication.
CONCLUSION: