A 47-year-old woman with CPP since she was 34 years old due to a sacrococcygeal fracture.
With irritative pain at the same level, she was submitted to a coxigectomy by the guardian for algological management.
The patient reported severe neuropatic pain (burning, paresthesias and electrical discharges) in the external genitalia (VAS 8/10) after the surgical procedure.
In the unit, as a first measure after 13 years of pain, oral neuromodulators were used: pregabalin (150 mg/12 hours), amitriptyline (25 mg/every night) and tramadol (200 mg/12 hours).
Due to the lack of pain relief, following the protocol, CENPP was performed in June 2006.
An initial Oswestry with disabling functional limitation (34 points equivalent to 68 % disability) was reported.
A psychological interview with the presence of depression and moderate anxiety, which did not contraindicate the implant.
The patient was programmed for NERSR in the catheterization laboratory by fluroscopic control, standard monitoring and with absolute asepsis. The L2-grade approach to the epidural space decreased to the L3-4.
After a test period of 5 days in which there was satisfactory pain relief for the patient (VAS 2-3/10, Oswestry proceeded with moderate functional limitation (20ERS points equivalent to 40 % of disability) in the lumbar ball.
One month after treatment, the patient was free of perineal pain.
Currently, the patient has VAS 2/10, being treated with pregaballin 75 mg daily.
Presents in his current assessment of psychoberg a mild depression and moderate anxiety according to Beck depression and Golds health questionnaire.
