1. 2012;15;303-309Cervical Spinal Cord Stimulation with 5-Column Paddle Lead In Raynaud’s Disease
   Case Report
   Mohammed A. Issa, MD, and Chong H. Kim , MD.

OBJECTIVE: To report a case of Raynaud disease and its successful treatment with spinal cord stimulation utilizing the newly designed five-column Penta™ lead paddle. Specific electrode design, programming characteristics, and surgical technique are also discussed in this case.

DESIGN: Case Report.

SETTING: University pain management center.

BACKGROUND: A 65-year-old man with Raynaud disease presented with neck and upper extremity pain. The patient also had herniation and spondylosis of the lumbar spine and intervertebral disc disease of the cervical spine. An examination revealed venous changes, chronic ulceration, and digit discoloration in upper and lower extremities.

METHOD: Conservative management and pharmacological treatment were ineffective. Sympathetic block produced significant but limited improvement. Treatment with spinal cord stimulation was tried after a successful 7-day trial.

RESULTS: Initial stimulation of the cervical spine with two octapolar leads at the C2 level produced greater than 75% pain improvement. However, the patient lost coverage shortly after discharge due to lead migration which could not be regained with reprogramming. A revision with Penta™ lead paddles produced sustainable and significant paresthesia coverage.

LIMITATIONS: A case report.

CONCLUSION: We report the successful application of spinal cord stimulation utilizing a five-column paddle lead in an individual with severe refractory Raynaud disease.