SCS has demonstrated effectiveness in the management of chronic intractable back and leg pain, most often when surgical and medical therapeutic options have been exhausted. Although comorbid pain conditions are often present, patients usually receive SCS for a specific pain disorder in a single dermatome. The following case, based on retrospective chart review, reports the successful treatment of neuropathic pain secondary to abdominal surgical resection and diabetic peripheral neuropathic pain in the lower extremities with the Precision™ SCS system.

A 36-year old male presented with pain in the upper right quadrant secondary to a surgical procedure and in bilateral lower extremities secondary to diabetic complications. Following numerous failed treatments including opioids, NSAIDs, TENS, physical therapy, and sympathetic blocks, the patient was successfully trialed and implanted with two percutaneous leads placed in tandem at T5/6 and T7/8.

The patient reported a prestimulation VAS rating of 10 on a 10 point scale and a VAS of 1 when the stimulation was turned on. Only 8 weeks after permanent implant, the patient had decreased use of pain medication, resumed activities of daily living, and had improved sleep quality. Most importantly, since he no longer required opioids, he was able to return to work as a lieutenant police officer.

The treatment of any pain condition in the context of other diseases is a grave challenge for clinicians. The patient is more aggressively treated for the most debilitating ailment. However, in situations where the patient suffers from more than one neuropathic pain disorder distributed across more than one dermatome, strategic placement of multiple independent contact controlled leads should be considered.