Introduction: Residual limb pain is the pain affecting the remaining part of the limb (stump) where the amputation occurred. Residual limb pain often has a medical reason, such as nerve damage or entrapment (pressure on the nerve).

Case Report: A 54 yr/M  patient with right lower limb traumatic amputation (above knee amputation) referred to pain clinic with severe intensity residual limb pain. Minimal and transient pain relief despite multiple treatment, patient was explained about the sacral cord stimulation and a trial was planned. A straight tip epidural needle (16G Crawford needle) was inserted under fluoroscopic guidance through the sacral hiatus space and placed at S2 level. A 19G stimulating electrode (COSMAN electrode RCE TM 40cm) with active tip of 15mm was introduced through the epidural needle and the tip was placed at the L5 vertebral body. The right lower limb was stimulated after cauda equina stimulation was achieved with sensory stimulation at 50Hz, 0.6V and motor stimulation at 2Hz,0.8V. Pulsed RFA was done at 42oC for 10 minutes. Procedure repeated at S1 and S2 level and maximum stimulation almost at his pain site at S2 level. Local anaesthetics and steroids were avoided to reduce result bias. VAS decreased from7 to 5 in recovery room and 2-3 after one week of procedure.

Conclusion: With the limited resources and affordability issues of patient for spinal cord stimulation kit, we performed a successful trial of cauda equina stimulation with the use of Crawford epidural needle and  a stimulating electrode and proceeded with PRF in the same sitting.