Background

Anterior cutaneous nerve entrapment syndrome (ACNES) is a painful condition that can be refractory in a small percentage of patients. Abdominal pain caused by thoracic nerve entrapment in the abdominal wall characterizes ACNES. In the small number of refractory patients to all standard treatments, medication overuse and abuse are serious problems. Dorsal root ganglion (DRG) stimulation might be a good treatment to improve pain scores and to lower medication use.

Methods

We describe the retrospective analysis of 9 cases of patients who underwent DRG stimulation for refractory ACNES using a treatment algorithm. We focused on reported pain intensity scores, medication use and adverse events.

Results

All nine patients experienced a decrease in pain intensity during the trial period and received a permanent pulse generator implantation. Three months after permanent implantation, 8 out of 9 patients showed a pain reduction of more than 50%. Medication use was substantially lower.

Discussion and conclusion

This case series shows that DRG stimulation might be a very good treatment for refractory ACNES.