343 posters, 5 videos, 2 audios, 18 topics, 33 sessions, 263 authors, 202 institutions

24th Annual Pain Medicine Meeting 2025

November 13-15, 2025| JW Marriott Austin, Austin, Texas

2190680

Restorative Neurostimulation of lumbar multifidus muscles in a patient with severe degenerative lumbar scoliosis.

Medically Challenging Cases

Restorative Neurostimulation of lumbar multifidus muscles in a patient with severe degenerative scoliosis

Muhammad Anwar, MD, MBA; John Ward, MD; Kevin Vorenkamp, MD, FASA

Background:

Chronic non-specific low back pain (LBP) is associated with many etiologies
Multifidus dysfunction (MD), characterized by impaired neuromuscular control and muscle atrophy, is a common etiology of LBP
LBP with associated MD is seen in patients with degenerative scoliosis
Restorative neurostimulation shows promise for managing LBP related to MD

Case:

76 year-old female with 20-year history of progressively worsening LBP and right leg pain
Pain has be unresponsive to conservative therapies and injections.
Current medication regimen includes gabapentin, etodolac, acetaminophen, cyclobenzaprine and tramadol
Known severe degenerative scoliosis
MRI confirmed grade 2 (>50%) multifidus atrophy
For management of symptoms, Reactiv8 regenerative neurostimulation device implanted

Outcome:

12 day post operative visit: No complications. Right-sided lead was activated. Therapy sessions initiated
10 week follow up: Subjective improvement in pain and functionality, requiring less etodolac and acetaminophen, Left-sided lead activated, Reports ongoing right leg pain
15 month follow up: Patient undergoes right total hip arthroplasty for management of right leg pain
19 month follow up: Ongoing relief of back pain, Patient able to discontinue use of tramadol

Discussion

Restorative neurostimulation shows promise as pain management strategy for patients with scoliosis and MD.
Further research is needed to determine overall safety, feasibility and efficacy