On the therapeutic viability of peripheral nerve stimulation for ilioinguinal neuralgia: putative mechanisms and possible utility

Pain Practice : the Official Journal of World Institute of Pain
Jacob J RauchwergerCarey-Walter F Closson

Abstract

Injury to the ilioinguinal nerve commonly follows during lower abdominal and pelvic surgery, especially with inguinal hernia repair, appendectomy, and hysterectomy. Other potential causes include low abdominal blunt trauma, iliac crest bone graft, psoas abscess, Pott's disease, and prolonged wearing of abdominally constrictive clothing. The actual incidence of ilioinguinal neuralgia is uncertain, as reported percentage ranges between 12% and 62%. Prompt and accurate diagnosis is critical, and appropriate treatments range from conservative pharmacologic management with nonopioid (eg, gabapentin, topiramate) as well as opioid agents, to surgical neurectomy of the proximal portion of the ilioinguinal nerve. Pharmacological treatment is frequently unsuccessful (particularly if delayed) and while surgery is successful in approximately 73% of cases, it can result in problematic paresthesias, and pain may continue to persist in some patients. Thus, minimally invasive techniques, such as peripheral nerve stimulation, may be viable in those patients who are refractory to pharmacological management, as an option to surgery, and who have not gained satisfactory pain relief through surgical intervention. We present three cases of successfu...Continue Reading

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Citations

Jul 1, 2009·Neuromodulation : Journal of the International Neuromodulation Society·Joe Ordia, Julien Vaisman
Apr 1, 2010·Neuromodulation : Journal of the International Neuromodulation Society·William Porter McRoberts, Martin Roche
Oct 14, 2011·Neuromodulation : Journal of the International Neuromodulation Society·Alexander E YakovlevVictoria E Yakovleva
Jan 20, 2012·Neuromodulation : Journal of the International Neuromodulation Society·Frederikke RosendalTipu Z Aziz
Jun 8, 2012·Neuromodulation : Journal of the International Neuromodulation Society·Guilherme LepskiMatthias Morgalla
Oct 3, 2008·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·J WalterR Kalff
Jun 16, 2010·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·David ParrisIan Carroll
Mar 26, 2013·Journal of Clinical Anesthesia·Bryan SakamotoAndrew C Eppstein
Aug 2, 2011·Pain Practice : the Official Journal of World Institute of Pain·Patricia NelsonPhilip S Sizer
Apr 3, 2014·Pain Practice : the Official Journal of World Institute of Pain·Stefan SchuLiong Liem
Jan 22, 2020·Current Pain and Headache Reports·Lynn KohanAnna Irwin
May 11, 2020·Cirugía española·Raúl Medina VelázquezMaría José Luque García

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