"Spinal Cord Stimulation in Peripheral Arterial Disease: A 10-Year Systematic Review of Pain Relief and Limb Salvage Outcomes"

Abstract

This systematic review evaluated the efficacy and safety of Spinal Cord Stimulation (SCS) in patients with Peripheral Arterial Disease (PAD). The study analysed pain relief and limb salvage outcomes by systematically reviewing relevant literature published in the past ten years. Out of 191 records screened, a total of 10 studies were included, involving 1,079 patients. The selected studies used various research designs and assessed either pain levels or limb salvage, or both. Pain levels were mainly measured using Visual Analog Scale (VAS) scores at different follow-up intervals, showing significant pain relief over time. Limb salvage outcomes were described as limb survival rates or the percentage of patients requiring amputations, with positive results observed over time. The review acknowledges limitations, such as challenges encountered during the bias assessment and time constraints. Overall, the findings support the efficacy and safety of SCS and suggest its potential as a first-line treatment for conditions like critical limb ischemia (CLI), peripheral arterial disease (PAD), and peripheral vascular disease (PVD). It is recommended for future studies to use a single method for assessing pain levels, such as the Visual Analog Scale (VAS), and implement a standardized test to assess limb salvage as well, which ensures homogeneity of data and enables future meta-analysis. Eventually, it would be encouraged for future research and health professionals to employ artificial intelligence tools to anticipate the effectiveness of SCS for each patient individually before the condition deteriorates to the point where limb amputation becomes necessary.