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Neuromodulation in Pediatrics: Case Series

Kim, Eugene, MD; Gamble, Sean, MD; Schwartz, Adina, MA, OTR/L; Cucchiaro, Giovanni, MD

doi: 10.1097/AJP.0000000000000632
Original Articles

Objectives: Neuromodulation, particularly intrathecal drug delivery systems and spinal cord stimulators (SCSs), can be a valuable tool when treating chronic pain in adults. However, there is a paucity of literature with regard to its use in pediatrics.

Materials and Methods: We present a series of 14 children and adolescents with intractable pain who received a SCS or a pump for the intrathecal delivery of medications between 2010 and 2016 at our institution.

Results: During the study period, we placed 10 intrathecal pumps and 4 SCSs with an average age of 17 years old. Pain scores significantly improved after the implant (P<0.007) and function improved in 79% of patients. Opioid use was also significantly reduced. Three patients eventually had their device removed due to psychiatric comorbidities. Four patients had complications that were treated without further sequelae.

Conclusions: Neuromodulation can offer important options in treating some pediatric chronic pain patients. In-depth knowledge of primary disease and strict patient selection in the context of the patient’s social situation is vital to successful treatment.

Department of Anesthesiology Critical Care Medicine, Children’s Hospital Los Angeles, Los Angeles, CA

E.K. and G.C.: acquisition of data, analysis and interpretation of data, drafting of manuscript, and critical revision. S.G. and A.S: analysis and interpretation of data. S.G.: drafting of manuscript. A.S.: critical revision.

The authors declare no conflict of interest.

Reprints: Eugene Kim, MD, 4650 Sunset Boulevard, MS#3, Los Angeles, CA 90027 (e-mail: eugekim@chla.usc.edu).

Received October 23, 2017

Received in revised form April 20, 2018

Accepted May 14, 2018

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