Direct Peripheral Nerve Stimulation for the Treatment of Complex Regional Pain Syndrome: A 30-Year Review

Chmiela, Mark; Hendrickson, Mark; Hale, Jason; Chen, Liang; Telefus, Phillip; Sagir, Afrin; Stanton‐Hicks, Michael

doi:10.1111/ner.13295

Cited by 37 publications

(32 citation statements)

References 49 publications

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“…This exists as a more focal approach to specific nerves that have presented problematically with regards to response. One study utilized a surgical procedure that addressed specific neuropathy in upper and lower extremity nerves with the sciatic nerve being the most commonly affected in this cohort [ 104 ]. Significant improvements were seen in visual analog scale (VAS) pain rating, reduction of patients on concurrent opioid therapy, and improved functional outcomes [ 104 ].…”

Section: Current Treatmentmentioning

confidence: 99%

Complex Regional Pain Syndrome: A Comprehensive Review

et al. 2021

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Complex regional pain syndrome (CRPS) is a chronic pain condition often involving hyperalgesia and allodynia of the extremities. CRPS is divided into CRPS-I and CRPS-II. Type I occurs when there is no confirmed nerve injury. Type II is when there is known associated nerve injury. Female gender is a risk factor for developing CRPS. Other risk factors include fibromyalgia and rheumatoid arthritis. Unfortunately, the pathogenesis of CRPS is not yet clarified. Some studies have demonstrated different potential pathways. Neuropathic inflammation, specifically activation of peripheral nociceptors of C-fibers, has been shown to play a critical role in developing CRPS. The autonomic nervous system (ANS) is involved. Depending on whether it is acute or chronic CRPS, norepinephrine levels are either

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Section: Current Treatmentmentioning

confidence: 99%

Complex Regional Pain Syndrome: A Comprehensive Review

et al. 2021

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“…The case series generally support the RCTs, with greater than 50% relief in roughly two-thirds of the patients. A recent review of surgically implanted leads placed on peripheral nerves for treatment of CRPS over a 30-year time frame, documenting the experience at the Cleveland Clinic from 1990 to 2017, showed a mean 25% relief at 12 months [ 138 ]. This lower level of relief may reflect both the problems faced by earlier CRPS studies with appropriate diagnosis of the syndrome [ 143 ] and the potential complications associated with surgically implanted leads and generators.…”

Section: Resultsmentioning

confidence: 99%

“…Chmiela et al reported the complications seen in their 27-year history of surgically placed PNS leads for CRPS [ 138 ]. This review, like much of the early CRPS literature, did not show efficacy of the procedure in part because of the difficulty in diagnosing CRPS.…”

Section: Complicationsmentioning

confidence: 99%

Peripheral Nerve Stimulation for Chronic Pain: A Systematic Review of Effectiveness and Safety

et al. 2021

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“…CRPS type II is associated with a confirmed peripheral nerve injury, while CRPS type I is not associated with an apparent peripheral nerve injury. 1,2 There are four diagnostic tools for CRPS in adult populations. These include the Veldman criteria, IASP criteria, Budapest Criteria, and Budapest Research Criteria.…”

Section: Introductionmentioning

confidence: 99%

“…Such factors will generally determine the choice of which modality is more suitable as pain localized to a specific nerve territory or pain that is felt mainly distal in an extremity. 2 Destructive interventions in the DREZ zone for pain management have been used for many years, and the effectiveness of such interventions remains at a high level. 6 Unilateral epidural stimulation, and stimulation of the DREZ zone were described much less often in the literature.…”

Section: Introductionmentioning

confidence: 99%