Improvement In Neuropathic Pain,Proprioception, And Gait Stability After Spinal Cord Stimulator Implantation For Chemotherapy-Induced Peripheral Neuropathy

BACKGROUND: We present a patient with gait instability and pain due to chemotherapy-induced peripheral neuropathy (CIPN) who experienced marked improvement in motor function, proprioception, and pain following placement of a spinal cord stimulator (SCS). CASE REPORT: A 62-year-old woman underwent placement of a permanent SCS after failing conservative therapy to manage her severe CIPN. Preoperatively, she reported significant gait instability in addition to her pain, typically suffering 10 falls per month. Postoperatively, she experienced a pronounced reduction in her pain level from 8 of 10 to 2 of 10 and in her number of falls from 10 to 0 per month. Furthermore, we formally assessed gait speed and function, Timed Up and Go (TUG) testing, postural control, and lower extremity function before and after SCS placement, and we found a profound improvement in all measurements. CONCLUSIONS: For patients with CIPN, SCS devices represent an increasingly viable treatment option. Our patient demonstrated significant improvements in not only pain, but also surprisingly in her motor function and gait stability with SCS therapy. This case highlights a potential additional benefit of neuromodulation in patients suffering from CIPN. KEY WORDS: Balance, cancer pain, chemotherapy-induced peripheral neuropathy, gait speed, neuromodulation, neuropathic pain, paresthesia, proprioception, spinal cord stimulation