The Clinical Outcomes in Patients with Critical Limb Ischemia One Year after Spinal Cord Stimulation

Клинкова, А. С.; Kamenskaya, O. V.; Ashurkov, A V; Murtazin, Vladimir; Orlov, Kirill; Ломиворотов, В. В.; Караськов, А. М.

doi:10.1016/j.avsg.2018.12.093

Cited by 15 publications

(8 citation statements)

References 26 publications

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“…These results are in line with contemporary literature reports that demonstrate the efficacy of SCS in CLTI patients. 16,17,[21][22][23][24][25] The beneficial effects of spinal cord stimulation in patients with CLTI were also an increase in skin temperature in the ischemic area, consistent with results obtained by other groups. 22,26 Finally, the aim of SCS in PAD patients is not only to achieve effective analgesia, but also to promote the trophic-functional recovery of the body segment affected by an advanced ischemic process.…”

Section: Discussionsupporting

confidence: 89%

“…A recent report did show significant improvement in ABI in SCS-treated CLTI patients, although the proportion of patients with Fontaine stage III was higher and normalized measurements 1-year after SCS were not obtained. 21 Most patients with Fontaine stage III reported no pain 1 year after implant and their quality of life was considerably higher than in Fontaine stage IV patients. These outcomes suggest that treatment of CLTI with SCS is advantageous earlier rather than later in the stage III to IV disease progression, although both groups showed progressive and meaningful improvements up to 1-year follow-up.…”

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Improving Limb Salvage for Chronic Limb-Threatening Ischemia With Spinal Cord Stimulation: A Retrospective Analysis

Cyrek

Henn

Meinhardt

et al. 2021

Vasc Endovascular Surg

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Introduction: Chronic limb-threatening ischemia (CLTI) represents the most severe form of peripheral artery disease (PAD). Up to a third of CLTI patients are not eligible to receive first-line treatments such as bypass surgery or endovascular interventions. Epidural spinal cord stimulation (SCS) has been used as a method to improve microcirculatory blood flow and relieve ischemic pain in CTLI patients. The aim of the study was to evaluate limb salvage, ulcer closure, and clinical changes of SCS implanted CTLI patients at 1-year follow-up. Methods: Eligible patients had end-stage lower limb PAD unresponsive to medical therapy and not amenable to surgical reconstruction. Patients were candidates for amputation, but limb loss was not inevitable (Fontaine stage III and IV). Pain intensity and skin temperature in the ischemic area (visual analogue scale), quality of life (WHOQoL-BREF), and ankle/brachial blood pressure index (ABI) were recorded at routine follow-up visits. Data were analyzed retrospectively. Results: 29 patients underwent SCS implantation at one vascular center. The minimum follow-up period was 30 months. Limb survival at 1-year follow-up was 97% (28/29) and 73% (11/15) had complete closure of limb ulcers. Pain intensity, skin temperature, and quality of life progressively improved up to 12 months after implant, with Fontaine stage III patients improving more substantially than Fontaine stage IV patients. SCS therapy did not affect ABI measurement. No complications related to the device or procedure occurred. Conclusions: SCS is a valid alternative in patients unsuitable for revascularization. The quality of results depends on both a strict selection of patients by vascular specialists and the frequency of follow-up controls. The therapy may be more beneficial in patients classified as Fontaine stage III.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 92%

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Improving Limb Salvage for Chronic Limb-Threatening Ischemia With Spinal Cord Stimulation: A Retrospective Analysis

Cyrek

Henn

Meinhardt

et al. 2021

Vasc Endovascular Surg

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“…After surgery of ACCF and PCDL, the dural sac and flattened spinal cord were all expansion in this series cases. As previous study shown, the dural sac and spinal cord expansion can lead to spinal cord ischemia-reperfusion injury [33,20,31,34]. In this series, the compression of spinal and expansion of dural sac and flattened spinal cord were similar between two groups.…”

Section: Discussionsupporting

confidence: 72%

“…Long term of OPLL compression spinal cord in CSM patients lead the nerve tissue is starved of vital nutrients such as oxygen and glucose [35,33,26,34]. Multiple mechanisms of cell damage are activated following spinal ischemia and reperfusion which can be a function of location in the spine as well as the time elapsed since the onset of ischemia [30,3,27,36,32].…”

Section: Discussionmentioning

confidence: 99%

C5 palsy in the treatment of cervical spondylosis myelopathy with ossification of the posterior longitudinal ligament

Yan¹,

Zhang²,

Zhang³

2020

Preprint

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Background There are many factors that affect the C5 palsy in the treatment of cervical spondylosis myelopathy (CSM) with ossification of the posterior longitudinal ligament (OPLL), but the spinal compression degrees may be an important factor in affection on it. Objective The purpose of this study was to evaluate the effect of spinal cord compression degrees on the clinical outcomes of OPLL patients which been treated by anterior and posterior surgery. Methods From May 2010 to October 2017, 145 patients cervical spondylosis myelopathy with OPLL (spinal canal narrowing by the OPLL exceeded 30%) were enrolled in this study; 76 patients received anterior cervical corpectomy and fusion surgery (ACCF), and 69 patients had posterior cervical decompression and laminoplasty procedures (PCDL). The clinical outcomes of pain relief (visual analog scale, VAS), functional disability (neck disability index, NDI) were recorded at baseline and at the final follow-up. Results There were five patients with C5 palsy in this series cases (two in ACCF and three in PCDL), and the rate is 4.1% (3.2% in ACCF and 5.2% in PCDL, P > 0.05). Five C5 palsy cases had more than 50% compressed degrees of dural sac and flattened spinal cord, and the compressed dural sac and flattened spinal cord had totally expansion after operation. There were no patients resented with CSF leakage in PCDL group, and six patients presented with CSF leakage in ACCF. The mean postoperative canal diameter were significant better than preoperative in PDL patients (P < 0.01). The average spinal sagittal and axial compressive ratio were significantly decreased from preoperative in ACR and PDL groups (P < 0.01). The mean cervical ROM values were decreased in ACR and PDL groups (P< 0.05). Conclusions Based on the results of this study, anterior and posterior surgery was effective and safe in the treatment of the OPLL patients. The complication of C5 palsy were no related in the surgery methods, but may be related the degrees of spinal cord compressed.

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Spinal Stimulators: Review of the Current Evidence

Jain,

Jumreornvong,

AlFarra

et al. 2024

Curr Phys Med Rehabil Rep

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The Clinical Outcomes in Patients with Critical Limb Ischemia One Year after Spinal Cord Stimulation

Cited by 15 publications

References 26 publications

Improving Limb Salvage for Chronic Limb-Threatening Ischemia With Spinal Cord Stimulation: A Retrospective Analysis

Improving Limb Salvage for Chronic Limb-Threatening Ischemia With Spinal Cord Stimulation: A Retrospective Analysis

C5 palsy in the treatment of cervical spondylosis myelopathy with ossification of the posterior longitudinal ligament

Spinal Stimulators: Review of the Current Evidence

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