Spinal cord stimulation in sympathetically maintained complex regional pain syndrome type I with severe disability. A prospective clinical study

Harke, H.; Gretenkort, P.; Ladleif, Hans Ulrich; Rahman, Salah

doi:10.1016/j.ejpain.2004.09.003

Cited by 147 publications

(105 citation statements)

References 40 publications

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“…However, among patients with neuropathic pain, only 34% of cases required revision. 2,5,6,10,15,17 In addition, in this study, the median RFS was 28 and 47 months for axial back pain and neuropathic pain, respectively (p = 0.39; Fig. 8).…”

Section: Revision Timelinementioning

confidence: 97%

Neuromodulation in intractable pain management: outcomes and predictors of revisions of spinal cord stimulators

Bir¹,

Konar²,

Maiti³

et al. 2016

FOC

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OBJECTIVE Spinal cord stimulators (SCSs) appear to be safe and efficacious for chronic intractable back pain. Although there are many reports on percutaneous SCSs, there are very few studies on outcomes of paddle lead SCSs. In addition, the predictors of requirement for SCS revision have not been well established. Here, the authors review the outcome of a case series and attempt to identify the predictors of SCS revisions. METHODS The clinical and radiological information of 141 patients with intractable chronic pain who underwent SCS implantation within the past 20 years was retrospectively reviewed. Paddle lead SCSs were used in this series. Statistical analysis was conducted using Kaplan-Meier curves and Cox proportional-hazards regression. RESULTS Among 141 cases, 90 (64%) did not require any revision after SCS implantations. Removal of the SCS was required in 14 patients. The average pain score was significantly reduced (preimplantation score of 8 vs postimplantation score of 1.38; p < 0.0001). Younger age, male sex, obesity, a preimplantation pain score ≥ 8, and the presence of neuromuscular pain were identified as predictors of the overall requirement for SCS revision. However, only a preimplantation pain score ≥ 8 was identified as a predictor of early failure of the SCS. CONCLUSIONS Implantation of a paddle lead SCS is a relatively less invasive, safe, and effective procedure for patients with intractable back pain. Revision of the procedure depends on many factors, including younger age, male sex, associated neuromuscular pain, and severity of the pain. Therefore, patients with these factors, for whom implantation of an SCS is planned, should be closely followed for the possible requirement for revision.

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Section: Revision Timelinementioning

confidence: 97%

Neuromodulation in intractable pain management: outcomes and predictors of revisions of spinal cord stimulators

Bir¹,

Konar²,

Maiti³

et al. 2016

FOC

View full text Add to dashboard Cite

show abstract

“…Depending on type of the electrodes, these systems can be implanted percutaneously, or surgically by a small laminotomy [3][4][5][6][7][8] . Increasingly, electrode placement for SCS has been through the percutaneous route, rather than via laminectomy, to reduce costs and to take advantage of minimally invasive techniques.…”

Section: Discussionmentioning

confidence: 99%

Epidural Anesthesia for Placement of Spinal Cord Stimulators with Paddle-Type Electrodes

Zhang

Bhatia²,

Oh³

et al. 2009

Stereotact Funct Neurosurg

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Background/Aims: Placement of paddle electrodes for spinal cord stimulation is usually performed under local anesthesia as the patient must be alert and cooperative during the procedure. This is often difficult, and involves significant discomfort for the patient. We explore the placement of spinal cord stimulators (SCS) under epidural anesthesia. Methods: Fifteen consecutive patients underwent single-shot epidural anesthesia prior to placement of the SCS. Patient perception of paresthesias during intraoperative stimulation was compared to preoperative pain dermatomes indicated by the patient. The ability to produce paresthesias as well as the voltage required to produce paresthesias under anesthesia were recorded. Patient demographics, amount and concentration of epidural drugs, use of local anesthetic or sedatives, and any complications were also recorded. Results: Epidural anesthesia was successfully induced in 14 patients. All patients were alert and cooperative. Paresthesias in appropriate dermatomes were induced in all patients. No local anesthetic or sedatives were used. The voltage required to induce paresthesias was double that required to maintain stimulation once the epidural had worn off. Conclusion: Epidural anesthesia provides a safe and effective means of placing SCS with paddle-type electrodes. There is no patient discomfort, and paresthesias are consistently elicited in appropriate areas in all patients.

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“…In terms of the neuropathic pain etiology, SCS has been applied in the treatment of deafferentation pain, central pain, phantom limb pain (PLP), causalgia, myelopathy, oncologic pain, lumbosacral fibrosis, postherpetic neuralgia (PHN), FBSS, CRPS, reflex sympathetic dystrophy (RSD), spinal cord, brainstem or brain injury, and others (3,(13)(14)(15)22,32,33,38,42,43,(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57).…”

Section: Results In Pain Managementmentioning

confidence: 99%

Spinal cord stimulation in the treatment of neuropathic pain: Current perspectives of indications, cost-effectiveness, complications and results

Camporeze

Simm

Estevão

et al. 2017

JHSCI

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Introduction:The spinal cord stimulation (SCS) has been described as a valuable neuromodulating procedure in the management of chronic and medically untreated neuropathic pain. Although many studies have discussed the use of this technique, a question still remains regarding its efficacy in different medical conditions with different etiology in the long term. The aim of this paper is to discuss the risks, complications, cost-effectiveness, and results of SCS in patients affected by chronic neuropathic pain based on the comprehensive literature review.

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Spinal cord stimulation in sympathetically maintained complex regional pain syndrome type I with severe disability. A prospective clinical study

Abstract: As a result of permanent pain relief under long-term SCS combined with physiotherapy, the functional status and the quality of life could be significantly improved in sympathetically maintained CRPS I.

Cited by 147 publications

References 40 publications

Neuromodulation in intractable pain management: outcomes and predictors of revisions of spinal cord stimulators

Neuromodulation in intractable pain management: outcomes and predictors of revisions of spinal cord stimulators

Epidural Anesthesia for Placement of Spinal Cord Stimulators with Paddle-Type Electrodes

Spinal cord stimulation in the treatment of neuropathic pain: Current perspectives of indications, cost-effectiveness, complications and results

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