Abstract
Neuromas are a difficult-to-treat peripheral nerve pathology that can cause crippling pain. Optimal treatment is widely debated as pharmacological intervention frequently is not sufficient and surgical interventions are plagued with recurrence. The majority of amputees report severe and chronic stump pain. Avoiding complex surgery at the stump site would prevent infection or wound dehiscence. Recent advances in neuromodulation with external pulse emitters allow for pain relief with localized nerve stimulation. The authors describe the novel placement of a sciatic nerve stimulator in a 77-year-old man for painful stump neuromas of the common peroneal and tibial nerves.The video can be found here: https://youtu.be/96kKs3qjtqc
Highlights
We have the pleasure of presenting our case using a peripheral nerve stimulator for terminal sciatic nerve neuromas in a 77-year-old amputee
1:08 To briefly summarize, neuromas are difficult-totreat painful entities caused by peripheral nerve trauma.[1]
About 20% to 30% of neuromas do not respond to treatment.[4]
Summary
We have the pleasure of presenting our case using a peripheral nerve stimulator for terminal sciatic nerve neuromas in a 77-year-old amputee. 1:48 Peripheral nerve stimulators prove to be a minimally invasive option for these patients. This allows for transdermal deliverance of the stimulation to the implanted electrode. We can see on this T1 coronal fat-saturated MRI of his right leg that he has two terminal neuromas of his sciatic nerve.
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