Pain reduction in amputees by long-term spinal cord stimulation

Krainick, J.-U.; Thoden, U.; Riechert, T

doi:10.3171/jns.1980.52.3.0346

Cited by 131 publications

(64 citation statements)

References 8 publications

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“…In 1980, Krainick studied the e ects of SCS in a group of 64 amputees. 41 In 29 patients (45%) he found an initial pain relief of more than 50%. After 5 years follow up this percentage had decreased to only 20%.…”

Section: Clinical Resultsmentioning

confidence: 94%

Spinal cord stimulation in chronic pain syndromes

Vaarwerk

Staal²

1998

Spinal Cord

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Spinal cord stimulation (SCS) has been used for more than 30 years now, and although it has shown to be e ective under certain well-described conditions of chronic pain, conclusive evidence on its e ectiveness is still sparse.There is a need for more prospective and methodological good studies, in order to prove SCS e cacy for new or still questionable indications and to reveal prognostic factors for successful application. Especially at this moment, when governments are trying to control and reduce their health care expenses, studies on the cost-e ectiveness of SCS are important.In contrast to the early years when SCS was applied by independent physicians exploring the ®eld of neurostimulation, the importance of information exchange and coordination of studies has now been recognized. Recent technical improvements of SCS devices may positively in¯uence clinical outcome.

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Section: Clinical Resultsmentioning

confidence: 94%

Spinal cord stimulation in chronic pain syndromes

Vaarwerk

Staal²

1998

Spinal Cord

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“…Figure 1 demonstrates the effect of tolerance in our study and the study by North et al [9] also demonstrates a gradual onset of longterm failure secondary to tolerance. It is believed that tolerance is due to 1) fibrotic changes surrounding the electrode tip, which causes insulation of electrical signals [10][11][12]; or 2) plasticity of pain pathways, which has been demonstrated in the spinal cord [13], thalamus [14], and cortex [15] in humans.…”

Section: Discussionmentioning

confidence: 98%

The role of spinal cord stimulation in the treatment of chronic pain postlaminectomy

Kumar

Toth

1998

Current Review of Pain

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S pinal cord stimulation (SCS) has become a common and effective method of treating chronic pain, including postlaminectomy pain. However, the indications for SCS and long-term efficacy have been debated. This article discusses our experience using SCS including indications for stimulation, surgical technique, prognostic factors related to long-term success, and the results of those patients who failed trial stimulation. We compare our experience with that of other published reports and provide a section on our overall impression and criticism of the procedure and its results.

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“…It is important to note, that the present rate of neurological injury refers only the immediate postoperative period. Rates of neurological injury due to cSCS will be even higher with known long-term neurological complications of cSCS including remote spinal cord injury from stimulator mass effect, 9 local tissue reaction causing cord injury, 5,16,21,30,34 and lead migration. Aside from direct cord injury, and epidural hematoma, associated neurological deficits remain a concern after cSCS and are described in case reports.…”

Section: Discussionmentioning

confidence: 99%

Rate of perioperative neurological complications after surgery for cervical spinal cord stimulation

Chan¹,

Winkler²,

Jacques³

2016

SPI

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OBJECTIVE Cervical spinal cord stimulation (cSCS) is used to treat pain of the cervical region and upper extremities. Case reports and small series have shown a relatively low risk of complication after cSCS, with only a single reported case of perioperative spinal cord injury in the literature. Catastrophic cSCS-associated spinal cord injury remains a concern as a result of underreporting. To aid in preoperative counseling, it is necessary to establish a minimum rate of spinal cord injury and surgical complication following cSCS. METHODS The Nationwide Inpatient Sample (NIS) is a stratified sample of 20% of all patient discharges from nonfederal hospitals in the United States. The authors identified discharges with a primary procedure code for spinal cord stimulation (ICD-9 03.93) associated with a primary diagnosis of cervical pathology from 2002 to 2011. They then analyzed short-term safety outcomes including the presence of spinal cord injury and neurological, medical, and general perioperative complications and compared outcomes using univariate analysis. RESULTS Between 2002 and 2011, there were 2053 discharges for cSCS. The spinal cord injury rate was 0.5%. The rates of any neurological, medical, and general perioperative complications were 1.1%, 1.4%, and 11.7%, respectively. There were no deaths. CONCLUSIONS In the largest series of cSCS, the risk of spinal cord injury was higher than previously reported (0.5%). Nonetheless, this procedure remains relatively safe, and physicians may use these data to corroborate the safety of cSCS in an appropriately selected patient population. This may become a key treatment option in an increasingly opioid-dependent, aging population.

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Pain reduction in amputees by long-term spinal cord stimulation

Cited by 131 publications

References 8 publications

Spinal cord stimulation in chronic pain syndromes

Spinal cord stimulation in chronic pain syndromes

The role of spinal cord stimulation in the treatment of chronic pain postlaminectomy

Rate of perioperative neurological complications after surgery for cervical spinal cord stimulation

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