A peer-reviewed, evidence-based journal for clinicians in the field of neuroscience
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Hot Topics in Pain Management [August 2016] 7 14 T H ANNUAL PAIN MEDICINE MEETING Highlights of selected poster presentations from the 2015 meeting November 19–21, 2015 • Miami Beach, Florida T he 14 t h A nnual Pain Medicine Conference held November 19 –21, 2015, covered topics such as new anticoagulation guidelines specific for interventional pain procedures; the influence of nanotechnology, stem cells, and gene therapy on pain medicine; platelet rich plasma (PRP) injections for sports injuries; cadaver and live model ultrasound and fluoroscopy-guided workshops on interventional techniques in cancer and non-cancer pain, and more. The highlighted poster presentation summaries below are just a few of many posters presented during the meeting. The complete list of poster abstracts for the 2015 meeting is available HERE. ÎPoster #674 Combined Sacral Nerve Roots Stimulation and Low Thoracic Spinal Cord Stimulation for the Treatment of Chronic Pelvic Pain Samer Abdel-Aziz from Medical College of Wisconsin Summary: In this retrospective case series, investigators describe the use of a combination of sacral nerve roots stimulation and thoracic spinal cord stimulation in the treatment of severe chronic pelvic pain in three patients with treatment-resistant severe pelvic pain. In all three patients, a SCS lead was placed and positioned over the dorsal column of the spinal cord. All patients reported immediate pain relief, and, on follow-up five days later, reported more than 50 percent pain relief and improvement in their daily activities. Investigators postulate that epidural sacral nerve roots stimulation may help patients with treatment-resistant pelvic pain and that adding a low thoracic SCS may improve pain relief by addressing pain escaping the sacral lead, suppressing the referred pattern of pain, or decreasing pain by suppressing the sympathetic outflow to the pelvis. ÎPoster #729 Management of Chronic Chemotherapy Induced Peripheral Neuropathy Using Neurostimulation Alaa Abd-Elsayed from University of Wisconsin Summary: Here investigators present a case of a patient with treatment-resistant, chemotherapy-induced painful peripheral neuropathy successfully treated by a spinal cord stimulator. The patient had received chemotherapy for treatment of non- Hodgkin's lymphoma. Cancer was in remission; however, the patient developed painful chemotherapy induced peripheral neuropathy in both hands. Investigators performed a spinal cord stimulator trial with placing 2 Octad leads into the cervical region at the level of C4-5. Patient reported a 70 to 80 percent improvement in his pain and in function and ability in his hands. Investigators proceeded with the permanent spinal cord stimulator implant, with continued improvement in the patient's pain and function. The investigators concluded that spinal cord stimulators may be an effective treatment for pain in patients with chemotherapy- induced peripheral neuropathy who have failed other pain management treatment regimens. ÎPoster #738 Topical Ketamine 10% for Neuropathic Pain in Spinal Cord Injury Patients: An Open Label Trial Joseph Rabi and Josh Minori from Schwab Rehabilitation Hospital/ University of Chicago Summary: The researchers sought to explore the effectiveness of topical ketamine as a treatment or adjuvant therapy for neuropathic pain in spinal cord injury (SCI) patients. In this open-label trial, researchers at an outpatient rehabilitation hospital recruited five patients with traumatic spinal cord injuries and neuropathic pain at or below level of injury. Subjects were instructed to apply topical ketamine 10% three times a day for a two week duration and keep track of their pain scores in a journal. The researchers reported a 10- to 50-percent decrease in the numerical pain score of all five patients by the end of two weeks with no adverse effects. The investigators postulate that the analgesic action is due to inhibition of serotonin-norepinephrine uptake blockade, NMDA receptor antagonism, and sodium channel blockade. Investigators concluded that topical ketamine 10% may be an effective analgesic in patients with spinal cord injuries but further placebo-controlled studies are needed to support this conclusion. ÎPoster #763 Do Patients with Chronic Cancer Pain Achieve Complete Pain Relief from Opioid Therapy? Results from a Systematic Literature Review. Brian Wetherington, Michael Harned, Mitzi Schumacher, and Paul Sloan from University of Kentucky Summary: Investigators sought to explore why a study of patients with chronic cancer pain who were treated with transdermal fentanyl and unlimited oral morphine found that the study subjects never rated pain lower than 30/100 on a visual analog scale. Specifically, the