Pain reduction through combined spinal cord stimulation and exercise therapy after spinal extradural arachnoid cystectomy: a case report.

IF 1.2 Q3 ANESTHESIOLOGY

JA Clinical Reports Pub Date : 2025-10-16 DOI:10.1186/s40981-025-00811-x

Akari Ikemura, Daigo Shiroki, Satoshi Ohga, Takafumi Hattori, Yoko Sugiyama, Yuko Kito, Maki Mizogami, Takako Matsubara, Hiroki Iida

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引用次数: 0

Abstract

Background: Spinal extradural arachnoid cysts (SEACs) can cause persistent pain after surgery. Combining spinal cord stimulation (SCS) with structured exercise therapy may aid long-term pain modulation.

Case presentation: A teenage female with over two years of severe rib pain and bilateral leg pain/numbness was diagnosed with SEACs and underwent resection. A trial of SCS alleviated leg symptoms; rib pain persisted. After SCS implantation, leg symptoms resolved, and a gradual exercise progressed from pain-free stretching to low-intensity lower-limb exercises. Over 12 months, rib pain decreased and skeletal muscle mass increased. Pressure pain threshold and conditioned pain modulation improved, suggesting reduced sensitization and enhanced descending inhibition.

Conclusions: This case suggests that SCS may provide early pain relief, enabling initiation of structured exercise, associated with sustained pain reduction, improved pain modulation, and functional recovery. These observations suggest the SCS combined with exercise may be a useful option for selected patients with movement-limiting multifocal pain.

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脊髓硬膜外蛛网膜囊切除术后脊髓联合刺激和运动治疗减轻疼痛1例报告。

背景：脊髓硬膜外蛛网膜囊肿（SEACs）术后可引起持续性疼痛。将脊髓刺激（SCS）与有组织的运动疗法相结合可能有助于长期疼痛调节。病例介绍：一名十几岁的女性，患有两年多的严重肋骨疼痛和双侧腿痛/麻木，被诊断为SEACs并接受了切除术。SCS缓解腿部症状的试验；肋骨持续疼痛。SCS植入后，腿部症状消失，逐渐从无痛拉伸发展到低强度下肢运动。12个月后，肋骨疼痛减轻，骨骼肌量增加。压痛阈值和条件疼痛调节改善，提示敏化降低和下行抑制增强。结论：该病例表明，SCS可能提供早期疼痛缓解，使开始有组织的运动，与持续的疼痛减轻，改善疼痛调节和功能恢复有关。这些观察结果表明，SCS结合运动可能是对运动受限的多灶性疼痛患者的一个有用的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.