Epidural Neurostimulation of Posterior Funiculi for the Treatment of Buerger's Disease

Background. Buerger disease is a nonatherosclerotic, segmental, occlusive and recurrent inflammatory vascular disorder that affects small and medium-sized arteries and veins of the upper and lower extremities.

Case reports. We report two cases of Buerger disease.

Medical History. Smoking habit. No autoimmune diseases. No diabetes mellitus. Intermittent vascular claudication at 100–150 m. Several hospital admissions for amputations.

Prior Medical Treatment. Antiplatelet agents, vasodilators, nonsteroidal anti-inflammatory drugs, third-step analgesics, fibrinolytic treatment and lumbar sympathectomies. Following all of the above treatments, Synergy^®spinal cord (ECP) stimulator with two electrodes (Quad PISCES^©) placed at the level of T9–T10.

Results. There has been a reduction in pain of about 80% and an improvement of intermittent claudication (one of the patients no longer claudicates, whereas the other patient claudicates at 400 m).

Conclusion. Neurostimulation of the posterior funiculi could be considered not only as palliative care but also as a therapeutic option.