Document resource
Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submissionBackground and Aims Intercostal neuralgia causes sharp, burning pain along the intercostal nerve distribution and can be refractory to conservative treatments. Standard management includes physical therapy, nerve blocks, and thermal ablation, but durable relief is often elusive. Dorsal root ganglion stimulation (DRGS) offers targeted neuromodulation but carries risks such as lead migration and infection, and thoracic applications remain off-label. Peripheral nerve stimulation (PNS) placed near the target nerve has emerged as a less invasive alternative, yet its use in bilateral thoracic intercostal neuralgia has not been reported.Methods We describe a 71-year-old woman with chronic, refractory intercostal neuralgia following multiple spine surgeries. After transient relief from thoracic paravertebral blocks, she underwent a 60-day trial of ultrasound- and fluoroscopy-guided PNS using the SPRINT MicroLead system. Percutaneous leads were positioned 1 cm superficial to the T7 dorsal root ganglia bilaterally, confirmed by patient feedback and imaging. Pain scores, medication use, and functional status were recorded throughout the trial and up to 18-month follow-up.Results During the trial, the patient reported 90% pain reduction on the left and 70% on the right, allowing cessation of gabapentin and improved sleep. No adverse events occurred, and lead integrity was confirmed at removal. At 18 months, she remained pain-free in the thoracic distribution, with only residual lower back discomfort unrelated to the trial. Her quality of life and daily activities showed marked improvement.Conclusions This first reported case of bilateral thoracic PNS targeting the T7 dorsal root ganglia demonstrates that percutaneous PNS can provide safe, effective, and durable relief for refractory intercostal neuralgia. These findings support further investigation of PNS as a minimally invasive neuromodulation strategy in this challenging patient population.