Stephen Music, MD, is a current PGY-3 anesthesiology resident at Rush University Medical Center, in Chicago, and a prospective pain medicine fellow. 

Throughout his residency, Music has published and submitted multiple pain medicine manuscripts, with more projects underway. He has given 15 case presentations at various national and regional conferences. Music currently has sought out active roles in pain medicine societies, such as supporting the North American Neuromodulation Society-Resident and Fellows Section (NANS-RFS) through creating educational video content. Through NANS-RFS, he has created videos on spinal cord stimulation (SCS): long-term care, perioperative management and anesthetic considerations, as well as SCS long-term outcomes and complications. The videos may be viewed through NANS-RFS social media accounts. Music was recently accepted into the ASRA (American Society of Regional Anesthesia and Pain Medicine) Resident Section Committee (February 2023) where he will support the science and practice of regional anesthesia and pain medicine through educational opportunities and membership and continue to publish acute and chronic pain content.

When OR and call shifts allow, he attends Rush pain medicine fellow educational courses on topics such as minimally invasive lumbar decompression, dorsal root ganglion (DRG) and SCS. He is also dedicated to supporting his co-residents through residency, as well as serving as a personal mentor and guide to prospective medical students.

One of Music’s publications, which he presented at ASRA’s 2022 Annual Pain Medicine Meeting, highlights the potential utilization of peripheral nerve stimulation (PNS) after failed dorsal root ganglion stimulation.

Music S,  Suvar T. Treatment of complex regional pain syndrome of the knee with peripheral nerve stimulation after failed dorsal root ganglion stimulation. Pain Medicine Case Reports. 2022;6(7):261-265. 

Complex regional pain syndrome (CRPS) is a chronic progressive neuropathic condition that generally presents following trauma, surgical procedures or develops spontaneously. Clinical recommendations are to pursue early multifactorial treatment modalities, such as physical therapy and psychotherapy, along with medications. If conservative treatment becomes insufficient, interventional treatments, such as DRG stimulation and PNS, have been proven effective measures in treating the condition. 

A 44-year-old woman who underwent multiple knee surgeries for osteoarthritis developed CRPS type II around her right knee. An L3/L4 DRG stimulator was implanted after conservative treatment failed. She reported 50% improvement and a reduced opioid requirement. Symptoms returned due to an L3 DRG lead fracture with an attempted revision. However, the patient experienced a postsurgical complication of neuroforaminal scarring, which precluded lead replacement and resulted in explantation.

A PNS implant was pursued with reported 75% to 80% symptom relief, titration off all medications and significant return of function. 

This case highlights PNS in treating advanced CRPS either as the initial neurostimulator of choice in selected populations or as an effective alternative treatment if DRG stimulation or SCS proves ineffective or unfeasible.