A woman in the UK is now pain-free for the first time in almost 40 years following a world-first nerve stimulation procedure.
Alison Cameron, 56, from Dorset, was fitted with the implant, pioneered by consultant neurosurgeon Girish Vajramani at University Hospital Southampton, in December.
The procedure involved placing four paddle-shaped electrodes across small collections of nerves in the spinal nerve known as the dorsal root ganglion (DRG).
These nerve ‘bundles’ are connected to every section of the vertebrae and are involved with sending pain messages to the brain.
In a further novel development, the paddle implant was combined with a standard spinal cord stimulator to create a hybrid model.
Mrs Cameron had suffered from chronic neuropathic pain following appendicitis surgery at the age of 17 which resulted in her requiring more than 50 injections to freeze the site of her pain, known as cryoblocks.
Unfortunately, none of the treatments and procedures attempted resolved her pain successfully for longer than six months and, subsequently, she required high doses of pain relief which left her unable to tolerate food and fluids.
Chronic pain affects between 33% to 50% of the population of the UK, with neuropathic pain, which is caused by nerve disease or nerve damage, accountable for up to 9% of all cases.
Due to multiple possible causes and because it can affect areas other than the initial site of the problem, it is challenging to treat and responds poorly to pain relief.
Mrs Cameron was referred to University Hospital Southampton five years ago after a cryoblock caused a collapsed lung. She received an initial standard percutaneous stimulation implant – delivered non-surgically through the skin – along the spinal nerve but this reduced her pain by just 50%.
She went on to require around 20 procedures to implant further electrodes, as well as revisions to correct leads which had moved position, and her pain could not be managed with medication.
Opinions on her condition had been sought from around the world but it was agreed the options were limited – which led to Mr Vajramani attempting to implant a paddle DRG implant and combine it with another device in a last-ditch attempt to reduce her levels of pain.
“Alison is one of the most challenging patients I have ever known and we really had tried everything for her – we had exhausted the options available,” said Mr Vajramani, who presented the findings at the North American Neuromodulation Society meeting.
“She had undergone 50 cryoblocks over 30 years which is unprecedented and resulted in her referral to me when this proved too dangerous. Our initial DRG stimulation implant provided some pain relief but it was not optimal and we could not prevent the need for medication.
“I made various enquiries to medical device companies to see if a paddle DRG model – to cover the affected nerves between the spine – was in development but there wasn’t, so we needed to find an alternative.”
He added: “Now, five months later, Alison has obtained 100% pain relief and her quality of life has improved fully for the first time in many years, I am delighted with the outcome so far but we will continue to monitor her closely.”
Alison said: “I can’t really describe what it feels like to be pain-free after all this time, I am just extremely grateful to Mr Vajramani for his persistence and desire to find a solution for me.
“Most people would struggle to believe the journey I have been on – I have been in pain from my teenage years to becoming a granny – but I hope my story can give hope to others that no matter how long you face adversity things can get better.”
Posted on Sunday 2 June 2019