Neurosurgical Interventions in the Management of Pediatric Burn Pain

Introduction: Severe, chronic burn pain affects roughly 20-30% of pediatric burn patients. Current therapies are mostly limited to oral and intravenous analgesics. Surgical interventions have mostly been limited to trauma and plastic surgery, and include nerve releases, neurectomy, scar revision/excisions, and contracture release. In this SCOPING review, we analyzed the state of the current literature regarding neurosurgical interventions in the treatment of chronic pain in pediatric burn survivors.

Methods: We conducted a SCOPING review of neurosurgical management of pediatric burn pain on the PubMed database using the PRISMA guidelines. We also applied the same search criteria, guidelines, and database in the adult population for comparative purposes.

Results: There were no articles regarding neurosurgical interventions of pediatric burn pain generated from our search. Conversely, our search within the adult literature generated 36 articles, most of which discussed plastic surgery interventions to treat chronic, refractory nerve pain.

Conclusion : Our study highlights the paucity of available studies and ultimately lack of available neurosurgical interventions for pediatric patients with chronic burn pain. Traditional neurosurgical interventions such as spinal cord stimulation or intrathecal pain pumps are of limited use in this population given issues with wound healing. Future research, procedural innovation, and collaboration amongst neurosurgeons, plastic surgeons, and pain interventionalists is critical to provide solutions and compassionate care for this undertreated population.