Abstract：
Anterior cutaneous nerve entrapment syndrome (ACNES) is a cause of moderate to severe chronic pain, hyperesthesia/hypoesthesia, and altered perception of heat/cold in a specific region of the anterior abdominal wall, referable to the territory of innervation of one or more anterior branches of the intercostal nerves. None of the therapeutic options currently available has proved to be effective in the long term or decisive. In recent years, we have begun to treat purely sensory neuropathies, such as this, with the implantation of wireless peripheral nerve stimulators (PNS), achieving the safety of modular and personalized analgesia. We report the case of a 41-year-old man suffering from ACNES of the 8th intercostal nerve for two years. We first performed two consecutive ultrasound-guided diagnostic blocks of the anterior cutaneous branch of the 8th intercostal right nerve and then elected the patient for ultrasound-guided nerve decompression followed by neuromodulation and pulsed-radiofrequency (PRF). Taking into account full employment, young age, and the likelihood of having to repeat the treatment several times, we considered him for Peripheral Nerve Stimulation (PNS) implantation under ultrasound guidance, and we implanted the wireless lead at the anterior branch of the right 8th intercostal nerve, and programmed tonic stimulation 100 Hz PW 200 ms. The patient reported immediate pain relief and never took medication for this problem again, at two years follow-up. PNS has had an increasing role in the management of chronic neuropathic pain, especially in merely sensitive neuropathies like ACNES. We support future research on this theme.
摘要：
前皮神经卡压综合征（ACNES）是中度至重度慢性疼痛的原因，感觉过敏/感觉减退,并改变了前腹壁特定区域的热/冷感知，指肋间神经的一个或多个前支的神经支配区域。目前可用的治疗选择都没有证明是长期有效或决定性的。近年来,我们已经开始治疗纯粹的感觉神经病,像这样,随着无线周围神经刺激器（PNS）的植入，实现模块化和个性化镇痛的安全性。我们报告了一名41岁男子患有第8肋间神经ACNES两年的病例。我们首先对第8肋间右神经的前皮分支进行了两个连续的超声引导诊断块，然后选择患者进行超声引导神经减压，然后进行神经调制和脉冲射频（PRF）。考虑到充分就业，年轻的年龄,以及必须重复多次治疗的可能性，我们考虑他在超声引导下进行周围神经刺激（PNS）植入，我们在右第8肋间神经前支植入了无线导线，和编程的强直刺激100HzPW200ms。患者报告疼痛立即缓解，并且再也没有因为这个问题服用药物，在两年的随访中。PNS在慢性神经性疼痛的治疗中起着越来越重要的作用，尤其是在像ACNES这样的敏感神经病中。我们支持未来对这一主题的研究。
