Does Interventional Pain Management Play a Role in the Treatment of Cervical Post-Surgical Neuropathic Pain?

Post-surgical neuropathic pain is still an underdiagnosed medical condition with persistent pain occurring in 10-50% of patients submitted to surgery. We present a case of a 52-year-old patient with persistent paracervical, supraclavicular, and upper chest neuropathic pain after the excision of a massive deep right cervical tumor, concluded to be an accessory spinal nerve schwannoma. A thorough physical and ultrasound examination helped conclude injury of the superficial cervical plexus. Therefore, an ultrasound-guided hydrodissection of several neuromas was performed at the level of the superficial cervical plexus. After three procedures, pain and quality of life scores improved, with a reduction of anxiety and depression symptoms. Due to the positive response, the patient was referred for a peripheral nerve stimulator implantation, allowing self-control of pain, in a home setting.