The Effect of Percutaneous Epidural Stimulation of the Spinal Cord for Brachial Plexopathy / 대한마취과학회지

ABSTRACT

Spinal dorsal column stimulation is one of the effective treatment for some patients with medically and surgically intractable pain. The rationale for dorsal column stimulation has been the "gate theory" of pain proposed by Melzack and Wall. We procedured the percutaneous epidural stimulation of the spinal cord in the patient with left brachial plexopathy by the traffic accident. The pain was causalgic and intractable to the conventional treatment. The procedure was done in the operating room with aseptic technique under C-arm radiographic guidance. The 16G Tuohy needle was advanced through the T3-4 interspace into the epidural space and then the electrode was inserted through the needle and advanced in the epidural space so that the tip rested on C2 body. The position of the tip of electrode was checked by fluoroscopy with image intensification with C-arm. The test stimulation was carried out using 3.5 volt for one week. The patient experienced a good pain relief and also a comfortable paresthesia of the painful left upper extremity and had no major complications. The electrode was removed to be replaced with a permanent one.