Abstract

Neuropathic pain in lower extremities related lumbar post laminectomy syndrome (PLS) is a vague term defined clinically as persistent or recurrent neuropathic pain following otherwise anatomically successful surgery on the lumbar spine. We present a case of refractory chronic right lower extremity neuropathic pain of the foot in a 22-year-old man who underwent surgical posterior decompression of L1 laminae and Right transpedicular decompression with posterior T12-L2 fusion. The pain was refractory to conventional medications and adjuvants like anticonvulsants, antidepressants, muscle relaxants including common interventional pain procedures on the spine and lower extremity. Spinal cord stimulation is being increasingly used for such complex refractory pain but it comes with its inheritent risk in addition to cost and long term sequele. To avoid the limitations of spinal cord stimulator and patient refusal we placed Bioness Stim Router Permanent Placement of PNS Leads, percutaneously under ultrasound guidance to the right tibial and right peroneal nerves for the right lower extremity neuropathic pain of the foot. Patient reported more than 90% decrease in pain severity associated with significant reduction in overall oral analgesics post implantation.