Treatment of Postthoracotomy Intercostal Neuralgia with 60-Day Percutaneous PNS: Report of 2 Cases

Abstract

Background: Intercostal neuralgia is a debilitating condition that commonly occurs following thoracic surgeries. Presented here are 2 cases that highlight the potential of percutaneous peripheral nerve stimulation (PNS) targeting the intercostal nerves to provide immediate and sustained pain relief without permanent implantation. Case Report: Two patients with chronic postthoracotomy intercostal neuralgia received up to 60 days of PNS with implanted percutaneous leads. Both patients reported 80%-90% reductions in pain intensity by the end of the 60-day PNS treatment. At last follow-up, 13-14 months after lead removal, both patients continued to report substantial levels of pain relief as well as cessation or significant reduction of opioid and non-opioid pain medications. Conclusion: These cases suggest that 60-day percutaneous PNS may be applied to effectively treat nerve pain in the distribution of the intercostal nerves during the 60-day treatment and also may enable long-term sustained relief following the end of the PNS treatment period. Key words: Intercostal neuralgia, post-thoracotomy pain, chronic pain, peripheral nerve stimulation, neuromodulation, case report