Radiofrequency Probe Guidance in Peripheral Nerve Stimulator Placement for Complex Anatomy: A Case Report.

Background: Peripheral nerve stimulation (PNS) has been recognized for its efficacy in treating various pain conditions. However, its application in anatomically unique patients, especially those with achondroplasia, is not well established.

Case report: We describe a 30-year-old woman with achondroplasia suffering from neuropathic pain after total knee arthroplasty. Due to inadequate pain control from standard pharmacotherapy, she underwent PNS. Sensory stimulation was performed utilizing a radiofrequency ablation (RFA) probe to precisely locate the target sensory nerve. Once the correct sensory nerve was identified, the trajectory of the lead placement was adapted to the patient's anatomical features. The modified PNS implantation technique using RFA probe guidance resulted in substantial pain relief, reduction of opioid consumption, and no procedural complications.

Conclusions: The positive outcomes observed in this case underscore the potential for this innovative approach to be considered for use in those with variable anatomical challenges.