Spinal Cord Stimulation Combined with Anterior Cingulotomy to Manage Refractory Phantom Limb Pain

Background: Phantom limb pain (PLP) is an intractable and debilitating disease without satisfactory treatment options presently available. Central reorganization, peripheral changes, and psychiatric factors contribute to its development; thus, a neuropsychiatry-orientated combined therapy could be promising. Objectives: We used a combined strategy with the aims of demonstrating its therapeutic outcomes on PLP. Methods: The patient initially received spinal cord stimulation (SCS) implantation and then anterior cingulotomy (ACING) 2 years later. We administered the Hamilton Depression Scale-24, Hamilton Anxiety Scale, Pain Rating Index, Numerical Pain Rating Scale, and the Short Form (36) Health Survey to assess its outcomes at 5 time points, namely the time before performing SCS implantation, 1 year and 2 years after SCS implantation, and 1 year and 2 years after SCS combined with ACING. Results: Excellent pain relief and significant improvement in depression symptoms were observed in this patient with PLP who underwent SCS combined with ACING. Conclusions: This report suggests that SCS combined with ACING is efficacious for PLP. However, further studies are warranted.
Stereotact Funct Neurosurg 2018;96:1–5

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