Back
 OJAnes  Vol.2 No.3 , July 2012
Topographical Anatomical Neuropathic-Pain Guided (TANG) Mapping: A Tool Derived from a Patient Perspective to Facilitate the Transition from Spinal Cord Stimulator Trial to Potential Permanent Implantation
Abstract: Introduction: Collecting a patient’s pain scores and the analgesic effect achieved during spinal cord stimulation (SCS) trials can be difficult, and no standard exists for doing so. We propose a topographical mapping tool that was derived from a patient’s perspective. Case: A 60-year-old man with postherpetic neuralgia (PHN) underwent a SCS trial after conservative treatment failed to relieve his pain. During the SCS trial, with the SCS off and on in five different settings, he recorded pain levels in each of the six different painful zones he identified. The data collected were transferred to a topographical and anatomical map, which helped the physicians to better understand the effects of the SCS at different settings. Ultimately, the data collected by the patient helped the physicians to implant a permanent SCS successfully. Conclusions: Patient pain diaries have been used in pain medicine for years. This particular patient’s collection of pain scores and SCS effects inspired the construction of a more standardized tool for collecting such data during SCS trials. We propose that use of our Topographical Anatomical Neuropathic-pain Guided (TANG) mapping tool will enable physicians to choose SCS lead positions more precisely than is currently possible.
Cite this paper: N. Tang, B. Christensen and K. Williams, "Topographical Anatomical Neuropathic-Pain Guided (TANG) Mapping: A Tool Derived from a Patient Perspective to Facilitate the Transition from Spinal Cord Stimulator Trial to Potential Permanent Implantation," Open Journal of Anesthesiology, Vol. 2 No. 3, 2012, pp. 93-97. doi: 10.4236/ojanes.2012.23022.
References

[1]   R. H. Dworkin and R. K. Portenoy, “Pain and Its Persistence in Herpes Zoster,” Pain, Vol. 67, No. 2-3, 1996, pp. 241-251. doi:10.1016/0304-3959(96)03122-3

[2]   R. H. Dworkin, J. W. Gnann Jr, A. L. Oaklander, S. N. Raja, K. E. Schmader and R. J. Whitley, “Diagnosis and Assessment of Pain Associated with Herpes Zoster and Postherpetic Neuralgia,” Journal of Pain, Vol. 9, No. S1, 2008, pp. S37-S44. doi:10.1016/j.jpain.2007.10.008

[3]   A. Philip and R. Thakur, “Post Herpetic Neuralgia,” Journal of Palliative Medicine, Vol. 14, No. 6, 2011, pp. 765773. doi:10.1089/jpm.2011.9685

[4]   H. T. Benzon, K. Chekka, A. Darnule, B. Chung, O. Wille and K. Malik, “Evidence-Based Case Report: The Prevention and Management of Postherpetic Neuralgia With Emphasis on Interventional Procedures,” Regional Anesthesia & Pain Medicine, Vol. 34, No. 5, 2009, pp. 514-521. doi:10.1097/AAP.0b013e3181b137bd

[5]   A. J. van Wijck, M. Wallace, N. Mekhail and M. van Kleef, “Evidence-Based Interventional Pain Medicine According to Clinical Diagnoses. 17. Herpes Zoster and Post-Herpetic Neuralgia,” Pain Practice Vol. 11, No. 1, 2011, pp. 88-97. doi:10.1111/j.1533-2500.2010.00428.x

[6]   H. Harke, P. Gretenkort, H. U. Ladleif, P. Koester and S. Rahman, “Spinal Cord Stimulation in Postherpetic Neuralgia and in Acute Herpes Zoster Pain,” Anesthesia & Analgesia, Vol. 94, No. 3, 2002, pp. 694-700. doi:10.1097/00000539-200203000-00040

[7]   S. A. Greenberg, “The History of Dermatome Mapping,” Archives of Neurology, Vol. 60, No. 1, 2003, pp. 126-131. doi:10.1001/archneur.60.1.126

[8]   S. M. Falowski, A. Celii, A. K. Sestokas, D. M. Schwartz, C. Matsumoto and A. Sharan, “Awake vs. Asleep Placement of Spinal Cord Stimulators: A Cohort Analysis of Complications Associated With Placement,” Neuromodulation: Technology at the Neural Interface, Vol. 14, No. 2, 2011, pp. 130-135. doi:10.1111/j.1525-1403.2010.00319.x

[9]   T. Cameron and K. M. Alo, “Effects of Posture on Stimulation Parameters in Spinal Cord Stimulation,” Neuromodulation: Technology at the Neural Interface, Vol. 1, No. 4, 1998, pp. 177-183. doi:10.1111/j.1525-1403.1998.tb00014.x

[10]   E. Ross and D. Abejon, “Improving Patient Experience with Spinal Cord Stimulation: Implications of PositionRelated Changes in Neurostimulation,” Neuromodulation: Technology at the Neural Interface, Early View Online Version. doi:10.1111/j.1525-1403.2011.00407.x

[11]   G. Barolat, F. Massaro, J. He, S. Zeme and B. Ketcik, “Mapping of Sensory Responses to Epidural Stimulation of the Intraspinal Neural Structures in Man,” Journal of Neurosurgery, Vol. 78, No. 2, 1993, pp. 233-239. doi:10.3171/jns.1993.78.2.0233

[12]   J. Holsheimer, “Computer Modeling of Spinal Cord Stimulation and its Contribution to Therapeutic Efficacy,” Spinal Cord, Vol. 36, No. 8, 1998, pp. 531-540. doi:10.1038/sj.sc.3100717

[13]   J. Holsheimer, “Which Neuronal Elements Are Activated Directly by Spinal Cord Stimulation,” Neuromodulation: Technology at the Neural Interface, Vol. 5, No. 1, 2002, pp. 25-31. doi:10.1046/j.1525-1403.2002._2005.x

 
 
Top