Effective treatment of a digital ulcer and pain in a Raynaud's syndrome patient with using a spinal cord stimulator : A case report

Kim, Soo Jin; Kang, Girun; Lee, Mi Geum; Lee, Mi Kyoung; Choi, Sang Sik

Case Report

Spinal Pain

Anesthesia and Pain Medicine 2009;4(1):11-14.
Published online January 30, 2009.

Effective treatment of a digital ulcer and pain in a Raynaud's syndrome patient with using a spinal cord stimulator : A case report

Soo Jin Kim, Girun Kang, Mi Geum Lee, Mi Kyoung Lee, Sang Sik Choi

Department of Anesthesiology and Pain Medicine, Korea University College of Medicine, Guro Hospital, Seoul, Korea. clonidine@empal.com

Abstract

Raynaud's phenomenon associated with connective tissue disease (Raynaud`s syndrome) may be difficult to manage with conservative therapy, and no gold standard therapy currently exists. Raynaud's syndrome can cause digital ulcer and necrosis, digital amputation is inevitable in some patients. Spinal cord stimulation seems to be an effective treatment for ischemic vascular disease, although little is known about the mechanisms of this effect. We present here a case for which cervical spinal cord stimulation was used to treat a digital ulcer and the intractable digital pain in a 60-year-old male patient who had severe Raynaud's syndrome. The patient had Raynaud's phenomenon associated with mixed connective tissue disease for 10 years. Three years before visiting our clinic, he underwent amputation at the second and third distal phalanges of his right hand because of digital necrosis. Two months after spinal cord stimulator implantation, his pain significantly improved from 100/100 mm VAS to 0/100 mm and the function of his hands noticeably improved.

Key Words: digital ulcer, ischemic limb pain, Raynaud's syndrome, spinal cord stimulation