BACKGROUND: Central neuropathic pain that follows spinal cord injury is often refractory to medical therapy. Spinal cord stimulation (SCS) is an established treatment for chronic neuropathic pain, but conventional dorsal column placement may not capture all pain regions.

CASE REPORT: A 63-year-old man with C6-T2 spinal cord infarction and C7 ASIA C paraplegia experienced severe refractory pain in both feet and the left leg for over a decade. Two dorsal leads provided coverage for the feet but not the leg. An additional ventral lead at T12 captured the buttock and hamstring, reducing pain from 9/10 to 3/10. Permanent implantation yielded >80% relief at 2 years.

CONCLUSIONS: This case demonstrated durable relief with ventral SCS lead placement when dorsal stimulation alone was inadequate, underscoring the value of individualized strategies for central neuropathic pain as well as the potential for the role of ventral lead placement.

KEYWORDS: Spinal cord stimulation, case report, central neuropathic pain, spinal cord injury, ventral leads