gms | German Medical Science

64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

Subcutaneous Peripheral Nerve(-field) Stimulation (sPNS) in neuropathic pain – a case series

Meeting Abstract

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  • Murat Yavuz - Neurochirurgische Klinik, Universitätsklinikum Heidelberg
  • Andreas Unterberg - Neurochirurgische Klinik, Universitätsklinikum Heidelberg
  • Rezvan Ahmadi - Neurochirurgische Klinik, Universitätsklinikum Heidelberg

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocP 055

doi: 10.3205/13dgnc472, urn:nbn:de:0183-13dgnc4725

Published: May 21, 2013

© 2013 Yavuz et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: The subcutaneous peripheral nerve field stimulation (sPNS), as a minimal invasive and fully reversible neuromodulation technique, seems to be a promising treatment option for pain. This prospective study is designed to evaluate the efficacy of this method for the treatment of neuropathic pain.

Method: Patients suffering from circumscribed permanent pain at diverse localizations were enrolled to this trial, if the conservative therapy had failed. Eight-electrode testing-leads (octrodes) were placed subcutaneously into the region of interest (ROI). The electrodes were programmed postoperatively. After a 7±2 day trial the decision for a final implantation of a sPNS-system was made if the pain was reported to be decreased by at least 50 %. The pain intensity and quality of life was assessed by the German pain questionnaire “Deutscher Schmerz-Fragebogen” before and after the trial period. A short-time follow-up was done about four weeks after the final sPNS-system implantation.

Results: Four patients with neuropathic pain were treated by sPNS. In three of four cases (Meralgia paresthetica, parasacral pain and bilateral nape pain) two testing-leads were placed, followed by a final implantation of a sPNS-system after the trial period owing to 70 % pain reduction on average. After final implantation of the system, all patients reported about a significant improvement of quality of life. A single testing-lead was used in the genitofemoral neuropathy only. This patient didn't receive a sPNS-system because there was no reported change in pain at all.

Conclusions: The sPNS in dual-lead approach should be considered as an early effective, minimal invasive and fully reversible therapy modality in patients with circumscribed neuropathic pain. A long time follow-up with recruitment of more neuropathic pain patients is needed to clarify the complications, the long-time (side) effects and the advantage over other known neuromodulation techniques.