A Case of Spinal Cord Stimulation Therapy for Lower Limb Pain Due to Conus Medullaris Syndrome

This case report discusses the effective use of spinal cord stimulation (SCS) to treat lower limb pain caused by conus medullaris syndrome. A 49-year-old woman presented with persistent right lower limb pain and numbness following laparoscopic colon resection surgery. During epidural anesthesia, she experienced electric shock-like pain, which continued after surgery. MRI revealed fluid around the T12 thoracic spinal cord, suggesting spinal injury. Despite initial treatments, including epidural and nerve root blocks, the pain persisted. Further intervention with SCS led to significant pain reduction and improved mobility, enabling the patient to engage in rehabilitation. Conus medullaris syndrome, typically involving the T11-T12 to L2 spinal cord levels, can cause varied symptoms, including muscle weakness, atrophy, and radicular pain. In this case, the injury at the T11-T12 level presented with pain localized to the L2-L3 nerve root area, complicating the diagnosis. SCS, known for its efficacy in managing neuropathic pain, proved to be a suitable treatment for this patient, whose pain was refractory to conservative therapies. The treatment led to sustained pain relief and facilitated rehabilitation. This case highlights the diagnostic difficulties associated with conus medullaris syndrome; the symptoms of this condition may be similar to those of other conditions such as spinal pain. In this case, SCS was highly effective in treating neuropathic pain associated with spinal cord injury. In conclusion, SCS therapy provides significant relief for patients with conus medullaris syndrome, underscoring its importance in the management of chronic intractable neuropathic pain.