Spinal cord at the conus medullaris for treatment refractory pudendal: a case report

Pudendal neuralgia is a neuropathic pain syndrome consisting of debilitating pain along the pudendal nerve distribution. Current evidence offers a variety of therapeutic options, however many patients demonstrate inadequate pain control. We present a 56 year old woman with an eight year history of left groin, vaginal, and rectal pain consistent with pudendal neuralgia. After failing physical therapy, pharmacologic therapy, and surgical intervention, a spinal cord stimulator was placed at the conus medullaris with subsequent 65% pain relief and improved sitting time. This report demonstrates spinal cord stimulation uniquely targeted to the conus medullari as an effective treatment modality for pudendal neuralgia