Évaluation à long terme de la stimulation médullaire dans les douleurs lombosciatiques neuropathiques postopératoires : étude rétrospective

Abeloos, L.; Witte, Olivier De; Riquet, R.; Tuna, Turgay; Mathieu, N.

doi:10.1016/j.neuchi.2011.07.001

Cited by 15 publications

(6 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 4 Successful treatment outcomes are difficult to achieve for chronic pain which can, in the long run, adversely affect the patient, health care services, and eventually the society. Although SCS can successfully induce analgesia initially, this has been observed to be relatively temporary, with the analgesia usually wearing out after 12–24 months, 9 as in the presented study. In this scenario, the quick onset and prolonged analgesic effects obtained with cannabis-derived products seem to be independent of the effect of prior SCS therapy.…”

Section: Discussionmentioning

confidence: 54%

“… 5 The FBSS patients frequently suffer from moderate to severe chronic pain, associated with sensory and/or motor deficits, as well as other severe chronic pain syndromes associated with the persistence of low back pain, deterioration or recurrence of radiculopathy, and sphincter dysfunction. 6 , 7 The current therapeutic strategies for FBSS include antidepressant medications, antiepileptic medications, 8 deep brain stimulation, spinal cord stimulation (SCS), 9 , 10 epidural and intrathecal injections, 11 , 12 spine surgery, 13 counseling, 14 and exercise therapy. 15 FBSS is considered an intractable syndrome when various combinations of the existing therapeutic strategies prove ineffective.…”

Section: Introductionmentioning

confidence: 99%

“… 22 This pilot study aimed to evaluate the effect of a combination of delta-9-tetrahydrocannabinol (THC)/cannabidiol (CBD) in FBSS refractory to other available therapeutic strategies, including opioids, adjuvant drugs, radio frequency neuromodulating treatments, and SCS alone. The SCS, a treatment modality for chronic pain that has been in use since 1967, 9 is an expensive therapy and careful selection for its suitability is recommended. Remarkable technological advances over the years have resulted in electrodes transitioning from single to multi-contact arrays and stimulators from external radiofrequency coupled to implantable rechargeable devices.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cannabinoids and spinal cord stimulation for the treatment of failed back surgery syndrome refractory pain

Mondello¹,

Quattrone²,

Cardia³

et al. 2018

JPR

View full text Add to dashboard Cite

ObjectiveThis study aimed to evaluate pain and its symptoms in patients with failed back surgery syndrome (FBSS) refractory to other therapies, treated with a combination of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), in association with spinal cord stimulation (SCS).SettingsOutpatients referred at Pain Unit of San Vincenzo Hospital in Taormina (Italy), between September 2014 and January 2016.SubjectsEleven FBSS patients diagnosed with neuropathic pain using the Douleur Neuropathique 4 questionnaire and suffering from moderate to severe chronic refractory pain, and undergoing treatment with SCS and a combination of THC/CBD for 12 consecutive months.Materials and methodsAll the included patients discontinued previous unsuccessful therapy at least 2 months before the beginning of the cannabinoid therapy, with the exception of the SCS that was continued. Patients received a fixed dosage of cannabinoid agonists (THC/CBD) that could be increased subjective to pain control response. A Brief Pain Inventory questionnaire was administered to measure pain and its interference with characteristic dimensions of feelings and functions. The duration of treatment with SCS and THC/CBD combination was 12 months.ResultsEffective pain management as compared to baseline result was achieved in all the cases studied. The positive effect of cannabinoid agonists on refractory pain was maintained during the entire duration of treatment with minimal dosage titration. Pain perception, evaluated through numeric rating scale, decreased from a baseline mean value of 8.18±1.07–4.72±0.9 by the end of the study duration (12 months) (P<0.001).ConclusionThe results indicate that cannabinoid agonists (THC/CBD) can have remarkable analgesic capabilities, as adjuvant of SCS, for the treatment of chronic refractory pain of FBSS patients.

show abstract

Section: Discussionmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cannabinoids and spinal cord stimulation for the treatment of failed back surgery syndrome refractory pain

Mondello¹,

Quattrone²,

Cardia³

et al. 2018

JPR

View full text Add to dashboard Cite

show abstract

“…The degree of evidence was qualified in one systematic review, which showed level II-1 or II-2 by the U.S. Preventive Services Task Force for long-term relief [ 31 ]. Moreover, numerous studies have shown SCS effectiveness ( Table 1 ) [ 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 ]. Two randomized controlled trials compared SCS effectiveness with other treatments.…”

Section: Clinical Outcomes Of Each Treatmentmentioning

confidence: 99%

Neuropathic Pain after Spinal Surgery

et al. 2017

View full text Add to dashboard Cite

Neuropathic pain after spinal surgery, the so-called failed back surgery syndrome (FBSS), is a frequently observed troublesome disease entity. Although medications may be effective to some degree, many patients continue experiencing intolerable pain and functional disability. Only gabapentin has been proven effective in patients with FBSS. No relevant studies regarding manipulation or physiotherapy for FBSS have been published. Spinal cord stimulation (SCS) has been widely investigated as a treatment option for chronic neuropathic pain, including FBSS. SCS was generally accepted to improve chronic back and leg pain, physical function, and sleep quality. Although the cost effectiveness of SCS has been proved in many studies, its routine application is limited considering that it is invasive and is associated with safety issues. Percutaneous epidural adhesiolysis has also shown good clinical outcomes; however, its effects persisted for only a short period. Because none of the current methods provide absolute superiority in terms of clinical outcomes, a multidisciplinary approach is required to manage this complex disease. Further studies concerning the etiology, diagnosis, treatment, and cost effectiveness of FBSS are warranted to deepen our understanding of this condition.

show abstract

“…[1428] Insulated arrays implanted via laminectomy demonstrated performance advantages, in comparison with percutaneous electrodes. [22] As a matter of fact, several authors reported better coverage of pain[13] and clinical outcome[3121829] with fewer adverse effects.…”

Section: Introductionmentioning

confidence: 99%

Dorsal paddle leads implant for spinal cord stimulation through laminotomy with midline structures preservation

Mearini¹,

Bergomi²,

Panciani³

et al. 2012

Surg Neurol Int

View full text Add to dashboard Cite

Background:Pain relief obtained with spinal cord stimulation (SCS) in failed back surgery syndrome (FBSS) has been shown to be more effective with paddle leads than with percutaneous catheters. A laminectomy is generally required to implant the paddles, but the surgical approach may lead to iatrogenic spinal instability in flexion. In contrast, clinical and experimental data showed that a laminotomy performed through flavectomy and minimal resection of inferior and superior lamina with preservation of the midline ligamentous structures allowed to prevent iatrogenic instability. Aim of the study was to assess degree of instability and pain level in patients operated for SCS through laminectomy or laminotomy with midline structures integrity. The surgical technique is described and our preliminary results are discussed.Methods:Nineteen patients with FBSS underwent SCS, 12 through laminectomy and 7 through uni- or bilateral interlaminotomy with supraspinous ligament preservation. Postoperative local pain was evaluated at 15, 30, and 60 days. Static and dynamic X-rays were performed after 2 months.Results:The techniques allowed implanting the paddle leads in all cases. No intraoperative complications occurred. Local pain was higher and recovery time was longer in patients with laminectomy. We did not observe radiological signs of postoperative iatrogenic vertebral instability. Nevertheless, two patients who underwent laminectomy showed persistence of local pain after 2 months probably due to pathologic compensatory stability provided by the paraspinal musculature.Conclusions:The laminotomy is a minimally invasive approach that ensures rapid recovery after surgery, spinal functional integrity, and complete reversibility. Further studies are needed to confirm our preliminary results.

show abstract

Évaluation à long terme de la stimulation médullaire dans les douleurs lombosciatiques neuropathiques postopératoires : étude rétrospective

Cited by 15 publications

References 27 publications

Cannabinoids and spinal cord stimulation for the treatment of failed back surgery syndrome refractory pain

Cannabinoids and spinal cord stimulation for the treatment of failed back surgery syndrome refractory pain

Neuropathic Pain after Spinal Surgery

Dorsal paddle leads implant for spinal cord stimulation through laminotomy with midline structures preservation

Contact Info

Product

Resources

About