Spinal cord stimulation may improve not only intractable pain but also necrotic wounds

Abstract

Spinal cord stimulation (SCS), an implantable neuromodulation modality, is one of the most exciting developments in chronic pain syndromes. In addition, SCS may improve intractable pain and may help ischemic wound healing. Herein, we report a 59-year-old female patient with persistent neuropathic pain and peripheral arterial disease in the lower limb which was treated successfully with SCS.

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

“…With reference to (Figure 1), twelve narrative reviews [17][18][19][20][21][22][23][24][25][26][27][28] were excluded since they may have a potentially higher level of bias and generally interpreted data older than 10 years with no statistical results. Six systematic reviews [29][30][31][32][33][34] were excluded due to the inclusion of studies older than 10 years and the overlap of data that may lead to bias. Four case reports [35][36][37][38] were excluded since they covered individual cases or a limited number of cases, considering them weak evidence to make use of.…”

“…However, several limitations were encountered throughout the review process, including difficulties accessing the EMBASE database, limitations in the NOS bias assessment test, unavailability of full-text reports in some studies, errors in content generated by GPT-4, data heterogeneity, and time constraints. In light of the presented evidence from various systematic reviews, including Asimakidou, et al [29,31,33,34], the interpretation of the results suggests that spinal cord stimulation (SCS) shows great potential as an effective treatment for managing chronic pain of ischemic origin and preserving the affected limbs, particularly in patients with critical limb ischemia (CLI), peripheral arterial disease (PAD) and peripheral vascular disease (PVD). Moderate to high quality evidence that tonic SCS is effective in non-reconstructable CLI patients was brought up by Asimakidou, et al [28].…”

“…Additionally, it showed efficacy in both pain reduction and quality of life. Ubbink, et al [33] found that SCS significantly improved limb salvage after 12 months compared to standard conservative treat-ment alone. The SCS group also experienced significant pain relief and reduced analgesic usage.…”

“…De Caridi, et al [39] After SCS implantation and test stimulation, the pain was reduced by 50% on both the right and the left side in all our patients. The main indications for permanent SCS therapy after 1 week of test stimulation were represented by TcPO2 increase >75%, decrease of opiods analgesics use of at least 50% and a pain maintained to within 20-30/100 mm on VAS Abu Dabrh, et al [33] Tshomba, et al [44] The protocol for treadmill exercise used in this study consisted of walking at 2.5 km/h and 0% grade. Pain intensity was evaluated with the visual analog scale (VAS).…”