{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T03:46:17Z","timestamp":1791690377286,"version":"4.3.4"},"reference-count":33,"publisher":"BMJ","issue":"6","funder":[{"DOI":"10.13039\/100000005","name":"Department of Defense","doi-asserted-by":"crossref","award":["CDMRP\/PRORP W81XWH-12-2-0132"],"award-info":[{"award-number":["CDMRP\/PRORP W81XWH-12-2-0132"]}],"id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100019735","name":"SPR Therapeutics","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100019735","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2019,2,16]]},"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Chronic neuropathic pain is a common challenging condition following amputation. Recent research demonstrated the feasibility of percutaneously implanting fine-wire coiled peripheral nerve stimulation (PNS) leads in proximity to the sciatic and femoral nerves for postamputation pain. A multicenter, double-blinded, randomized, placebo-controlled study collected data on the safety and effectiveness of percutaneous PNS for chronic neuropathic pain following amputation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty-eight lower extremity amputees with postamputation pain were enrolled. Subjects underwent ultrasound-guided implantation of percutaneous PNS leads and were randomized to receive PNS or placebo for 4\u2009weeks. The placebo group then crossed over and all subjects received PNS for four additional weeks. The primary efficacy endpoint evaluated the proportion of subjects reporting \u226550%\u2009pain reduction during weeks 1\u20134.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A significantly greater proportion of subjects receiving PNS (n=7\/12, 58%, p=0.037) demonstrated \u226550% reductions in average postamputation pain during weeks 1\u20134 compared with subjects receiving placebo (n=2\/14, 14%). Two subjects were excluded from efficacy analysis due to eligibility changes. Significantly greater proportions of PNS subjects also reported \u226550% reductions in pain (n=8\/12, 67%, p=0.014) and pain interference (n=8\/10, 80%, p=0.003) after 8\u2009weeks of therapy compared with subjects receiving placebo (pain: n=2\/14, 14%; pain interference: n=2\/13, 15%). Prospective follow-up is ongoing; four of five PNS subjects who have completed 12-month follow-up to date reported \u226550%\u2009pain relief.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This work demonstrates that percutaneous PNS therapy may provide enduring clinically significant pain relief and improve disability in patients with chronic neuropathic postamputation pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT01996254\">NCT01996254<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rapm-2018-100109","type":"journal-article","created":{"date-parts":[[2019,4,6]],"date-time":"2019-04-06T07:05:12Z","timestamp":1554534312000},"page":"637-645","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":142,"title":["Percutaneous peripheral nerve stimulation for the treatment of chronic neuropathic postamputation pain: a multicenter, randomized, placebo-controlled trial"],"prefix":"10.1136","volume":"44","clinical-trial-number":[{"clinical-trial-number":"nct01996254","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Christopher","family":"Gilmore","sequence":"first","affiliation":[{"name":"Center for Clinical Research, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6144-3273","authenticated-orcid":false,"given":"Brian","family":"Ilfeld","sequence":"additional","affiliation":[{"name":"Anesthesiology, University of California, San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Rosenow","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Northwestern University, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Li","sequence":"additional","affiliation":[{"name":"Premier Pain Centers, Shrewsbury, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehul","family":"Desai","sequence":"additional","affiliation":[{"name":"International Spine, Pain & Performance Center, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corey","family":"Hunter","sequence":"additional","affiliation":[{"name":"Ainsworth Institute of Pain Management, New York City, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Rauck","sequence":"additional","affiliation":[{"name":"Center for Clinical Research, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Kapural","sequence":"additional","affiliation":[{"name":"Center for Clinical Research, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoun","family":"Nader","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Northwestern University, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Mak","sequence":"additional","affiliation":[{"name":"Premier Pain Centers, Shrewsbury, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5928-2127","authenticated-orcid":false,"given":"Steven","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6181-0806","authenticated-orcid":false,"given":"Nathan","family":"Crosby","sequence":"additional","affiliation":[{"name":"SPR Therapeutics, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Boggs","sequence":"additional","affiliation":[{"name":"SPR Therapeutics, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,4,5]]},"reference":[{"key":"2025101111381276000_44.6.637.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2007.11.005"},{"key":"2025101111381276000_44.6.637.2","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1093\/bjaed\/mkv028","article-title":"Pain after amputation","volume":"16","author":"Neil","year":"2016","journal-title":"BJA Educ"},{"key":"2025101111381276000_44.6.637.3","doi-asserted-by":"crossref","unstructured":"Nikolajsen L , Christensen KF . 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