S711 SPINAL NERVE ROOT STIMULATION IN THE MANAGEMENT OF INTRACTABLE LOIN PAIN. A CASE SERIES

Abstract

Aims: Intractable loin pain could lead to renal autotransplantation or nephrectomy, often with a poor outcome. We report seven cases of severe loin pain refractory to medical management as well as pain relief intervention successfully treated with spinal nerve root stimulation (SNRS). Methods:We reviewed eight patients who underwent SNRS for loin pain at our institute between 2003 – present date. The underlying pathology of the loin pain is variable among these patients; however, four of them are suffering from Loin pain hematuria syndrome (LPHS). A Quad Plus lead (Medtronic Ltd) was inserted percutaneously to cover T9/10 down to T11/12 nerve roots which produces paresthesia covering the painful area. Results: All the patients were successfully implanted after a trial period of 7–10 days. The pain relief provided by the stimulation is long lasting and the majority of the patients stopped or substantially reduced their opioid consumption. Successful implants have meant that some of the patients have avoided having to undergo a nephrectomy procedure to relieve the pain. Conclusions: Loin pain can originate form the kidney and related structures. Several invasive pain relief interventions have been used but unfortunately they provide only short-term pain relief. This case series shows that SNRS can be used for treating this difficult problem with good outcome.