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 Minimally invasive & reversible treatment option for chronic pain  Neuropathic pain  Few previous case reports in severe abdominal / pelvic visceral.

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Presentation on theme: " Minimally invasive & reversible treatment option for chronic pain  Neuropathic pain  Few previous case reports in severe abdominal / pelvic visceral."— Presentation transcript:

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2  Minimally invasive & reversible treatment option for chronic pain  Neuropathic pain  Few previous case reports in severe abdominal / pelvic visceral pain  No previous report in chronic renal pain

3  38 y/o Female with 15 year history of Rt sided flank pain & frequent UTIs  Clinical diagnosis of Congenital UPJO was made  No response to different interventions including stenting  Failed Conservative treatment  Minimal relief with opioids  Was finally referred to the pain clinic by Urology prior to undergoing robotic nephrectomy

4  Pain Level: 8/10 on VAS; 10/10 on flare-up episodes  Moderate pain on deep palpation of Abdomen and Rt flank region

5  Sympathetic Plexus Block:  Celiac Block: No benefit  Superior Hypogastric block: Benefit but of limited duration  Spinal Cord Stimulation

6 A single octad lead with the tip at the level of the mid 7 vertebral body, slightly right on center.

7  During 7-day Trial period:  85% pain relief  Did not take any oral pain medications  Improved overall function, sleep & mood  Permanent implantation performed 4 wks later  9 months later: only use OTC pain medications PRN

8  Gate Control theory (mainly somatic pain)  Suppress nociceptive viscero-motor reflex  Increase in local visceral blood flow

9  Patients with persistent chronic renal pain:  Conservative modalities should be utilized initially  More Interventional procedures as autonomic plexus block may be considered  If all failed:  SCS may provide a viable long-term option


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