Recently, the team led by Professor Xiao Hong from the Department of Pain Management at West China Hospital successfully performed a temporary spinal cord stimulation (t-SCS) implantation procedure on Mr. T (pseudonym), an American who had suffered from "Failed Back Surgery Syndrome" (FBSS) for over 20 years. The patient experienced significant pain relief post-surgery, with substantial improvements in sleep and daily activities, leading to a qualitative enhancement in his quality of life. This successful diagnosis and treatment not only demonstrated our hospital's international standards in the field of chronic intractable pain management but also builds a bridge for medical and health exchanges between China and foreign countries through concrete action.

Mr. T, now 58 years old, underwent multiple surgeries in the United States over 20 years ago for a lower back condition. Post-surgery, he gradually developed bilateral pain and numbness in his lower back and legs, with symptoms progressively worsening, leading to a diagnosis of FBSS. Over the years, he consulted various medical institutions and tried multiple interventions, including medication, nerve blocks, and radiofrequency therapy, but pain relief was unsatisfactory. His pain score remained persistently high at 7-8 (on a scale of 10), severely impacting his daily activities and nighttime sleep. After unsuccessful attempts to seek treatment elsewhere, Mr. T learned about the outstanding expertise of the West China Hospital Pain Management Department in managing refractory pain and traveled specifically across the ocean to Chengdu seeking systematic treatment.

Patient's Preoperative MRI

Upon admission, the Pain Management team conducted a comprehensive and systematic evaluation of the patient. Integrating his medical history, clinical manifestations, and imaging findings, they organized a multidisciplinary consultation and discussion. The team identified significant anatomical abnormalities in the surgical area, including postoperative scar adhesions and severe spinal canal stenosis, which substantially increased the technical difficulty and procedural risks of electrode placement. After repeated discussions within the multidisciplinary team and fully informing the patient of the treatment plan, it was decided to use temporary spinal cord stimulation as a means for efficacy testing and safety assessment. Based on the subsequent analgesic effect and tolerance, a careful evaluation would be made regarding the implantation of a permanent stimulation system. Consequently, a detailed, individualized surgical plan was formulated.

The surgery was performed under DSA (Digital Subtraction Angiography) guidance. Under the direction of Chief Physician Xiao Hong, the surgical team, consisting of Nurse Yin Yan and Research Assistant Lu Fan, precisely delivered the electrode to the corresponding segment of the patient's epidural space and completed intraoperative stimulation parameter adjustments. Mr. T immediately reported that the coverage area of the electrical stimulation highly coincided with his pain region, experiencing an immediate analgesic effect. The surgical procedure was completed smoothly.

Electrode Successfully Implanted

Postoperatively, a management team comprising Dr. Zeng Xianzheng, device engineers, and nursing staff provided continuous follow-up. Based on Mr. T's daily pain fluctuations, they meticulously optimized parameters such as stimulation intensity, pulse width, and frequency, ensuring the analgesic maintained optimal pain control. Remarkably, on the second postoperative day, Mr. T was able to discontinue the intravenous patient-controlled analgesia pump. The pain in his lower back and both legs was significantly alleviated; he enjoyed a restful night's sleep for the first time in a long while, and his ability to perform daily activities gradually recovered. "I tried many treatment methods in the US before, but the results were never satisfactory. I never expected to receive such systematic treatment here at the West China Hospital Pain Management Department," Mr. T exclaimed, full of praise for the treatment outcome. Upon departure, he gave the medical team a thumbs-up and repeatedly expressed his gratitude, thanking them for bringing him "a long-lost sense of ease and peace of mind."

Spinal cord stimulation, recognized internationally as a crucial treatment for refractory neuropathic pain, offers significant advantages such as being minimally invasive, reversible, and adjustable. Temporary spinal cord stimulation eliminates the need for implanting a permanent pulse generator, providing phased pain relief through a temporary electrode. This not only helps patients achieve rapid pain relief but also serves as an important basis for assessing suitability for long-term implant therapy. Compared to medication alone, this technology helps enhance analgesic efficacy while reducing analgesic consumption, thereby lowering the risk of drug-related adverse reactions, offering a safer and more effective treatment option for patients with intractable pain.

Since the Department of Pain Management at our hospital introduced this technology in 2022, it has completed over 170 related treatments, accumulating extensive experience in the standardized diagnosis, treatment, and individualized management of refractory neuropathic pain.