Spinal Cord Stimulation and Improved Hand Function in a Traumatic Upper Limb Replantation: A Case Report.

BACKGROUND

Spinal cord stimulation (SCS) is commonly used to treat chronic pain that is refractory to conservative management. SCS has demonstrated efficacy in reducing paresthesia and pain, but functional motor improvements after this type of intervention are reported less often.

CASE REPORT: A 70-year-old man sustained a traumatic left forearm amputation in 2015, which was followed by surgical reattachment and persistent neuropathic pain. The patient tried several interventions, including nonsteroidal antiinflammatory drugs, muscle relaxants, gabapentin, pregabalin, opioids, duloxetine, and nerve blocks. Ultimately, in 2017, he underwent the implantation of an SCS device. The SCS provided a maximum 90% reduction in pain and eliminated the paresthesias. The pain reduction notably helped double his range of motion when compared to pre-implantation interventions. He demonstrated improved range of motion, reduced muscle atrophy, and increased strength.

CONCLUSION

SCS provided both substantial pain relief and unanticipated functional recovery in this patient, whose upper limb had been amputated. This case serves to highlight a novel therapeutic benefit of SCS beyond pain relief.