918 - Bilateral Peroneal Neuropathy Secondary to Compartment Syndrome Treated with Peripheral Nerve Stimulation

Case Diagnosis: Bilateral Peroneal Neuropathy

Case Description: A 42-year-old male patient presented with bilateral peroneal neuropathy following acute compartment syndrome in both lower legs. The patient reported severe pain of 8/10 on VAS, weakness, and difficulty in ambulation despite conservative management, including physical therapy and pharmacologic interventions. Previous Electrodiagnostic testing revealed chronic bilateral deep peroneal neuropathy and left superficial peroneal neuropathy.
After evaluation, the patient was treated with SPRINT peripheral nerve stimulation targeting the bilateral sciatic nerves. The right side was treated first, and after good result the left side was treated approximately 2 weeks later.
Following a 60-day treatment period with SPRINT stimulation, the patient experienced significant improvement. Pain relief was reported as 90% on the right side and 70% on the left. Functional mobility improved, with the patient noting enhanced ability to walk and perform daily activities. In addition, he was able to return to Jiu Jitsu training. There were no reported adverse effects.

Discussions:

This case report highlights the use of peripheral nerve stimulation for peripheral neuropathy. As with most cases utilizing peripheral nerve stimulation, this patient had tried and failed multiple conservative treatments as well as surgical interventions. He had undergone peroneus brevis tendon and anterior talofibular ligament repair aimed to address his ankle instability with some success. However, his neuropathic pain remained unchanged, warranting trial of PNS. In this case, PNS was successful at alleviating pain and restoring function.

Conclusions: This case demonstrates that SPRINT peripheral nerve stimulation can be an effective and minimally invasive treatment option for managing pain and improving function in patients with peroneal neuropathy. The substantial reduction in pain and improvement in function observed in this patient suggests that peripheral nerve stimulation should be considered as a viable treatment modality for similar cases. Further research is needed to validate these findings and optimize treatment protocols.