Spinal Cord Stimulation and Whiplash Injury

Electrical spinal cord stimulation (SCS) is a technique used to treat a select group of patients with chronic, intractable pain. This case report investigates the effectiveness of SCS on a patient a whiplash-type injury.

The patient had a 4-year history of chronic pain, all stemming from a neck injury. His pain was localized into the left side of pharynx and the base of tongue radiating to the left cheek and ear. In course of his treatment heavy medications, physiotherapy, TNS-treatment, trigger joint injections, and stellate ganglion block were all tried but to no benefit. At this point, the treating physicians decided to try epidural spinal cord stimulation:

"As it is important to achieve stimulation paresthesias in the topographical representation of the patient's pain, we were forced to advance the tip of the electrode to the level of the base of the dens until satisfactory paresthesias were achieved. Interestingly, the first subjective feeling from stimulation was a warm, almost burning sensation over the previously painful area. During the trial stimulation pain symptoms started to disappear. First to give way were allodynia and hyperesthesia around the left ear. Last to disappear were the lancinating sensations, which sporadically appeared even a few weeks after the internalization of the system."

"SCS is an expensive and invasive way to treat pain. However, in addition to relieving pain and improving the quality of life of out patient, it has already caused considerable savings´┐ŻOur case shows that SCS can offer an alternative treatment in whiplash-type pain syndrome of this complexity."

At last assessment, the patient had been without pain and analgesics for 18 months.

Kirvela OA, Kotilainen E. Successful treatment of whiplash-type injury induced severe pain syndrome with epidural stimulation: a case report. Pain 1999;80:441-443.