Post Arteriovenous fistula surgery pain

Hi, I am asking on behalf of my friend in China.

She had a T12-L1 （due to congenital) Arteriovenous fistula surgery in Nov. 2007. After that, she has experienced painful atrophy of her left calf. Meantime, she has had a serious atrophy of  sciatic nerve in the lower buttock. The problem is that she has suffered from excruciating pain on a daily basis. She could neither sit nor stand as the pain is tremendous and it is hard for her to fall asleep at nights as well. The experts of a famous hospital in Shanghai said these were post-surgical complications, and there is currently no way to cure or alleviate the pain in China. She has tried traditional Chinese medicine, including injection of liquid medicine into acupuncture points. However, the situation has been getting worse. She is wondering if there is any medical practices/prescription in the States to alleviate her pain.

I’ve done some research about it myself, and i found that amputation and limb prosthesis are listed as the options for patients like her. Would there be any other options rather than this last resort?

Thanks

[Dr. Kokil Mathur]

Hi!
One possibility is Spinal cord stimulator which is a device inserted into epidural space or over the spinal cord with an Implantable power generator (IPG) under the skin of the lower abdomen or gluteal region. It is a method of giving controlled analgesia on demand. It is helpful in patients with inoperable back pain or limb pain. Normally the battery lasts 6-8 years. If you opt for re-chargeable battery (which is costlier), this will last 12-14 years. Usually IPG is effective for 5-8 years after which it needs to be replaced. During the trial period, the lead is placed on the spinal cord but the IPG is kept outside the body. If pain relief is 50% or more then the permanent procedure is carried out. Patients can keep the stimulator in off mode for varying periods of time and can lead a normal life. Since it is an invasive procedure, there is risk of bleeding, infection, and puncture of dura. The leads can get disconnected and would need another procedure to fix them. If you are on SCS, you will have to avoid procedures like pacemakers, MRI, diathermy, and repeated ultrasounds. Do discuss this with your doctor. Take care!