Section of Neurosurgery, Department of Surgery, Regina General Hospital, University of Saskatchewan, Regina, Saskatchewan, Canada.
Neurosurgery. 2011 Sep;69(3):566-78; discussion 5578-80. doi: 10.1227/NEU.0b013e3182181e60.
Complex regional pain syndrome (CRPS) I is a debilitating neuropathic pain disorder characterized by burning pain and allodynia. Spinal cord stimulation (SCS) is effective in the treatment of CRPS I in the medium term but its long-term efficacy and ability to improve functional status remains controversial.
To evaluate the ability of SCS to improve pain, functional status, and quality of life in the long term.
We retrospectively analyzed 25 patients over a mean follow-up period of 88 months. The parameters for evaluation were visual analog scale (VAS), Oswestry Disability Index (ODI), Beck Depression Inventory (BDI), EuroQoL-5D (EQ-5D) and Short Form 36 (SF-36), and drug consumption. Evaluations were conducted at point of entry, 3 months, 12 months, and last follow-up at 88 months (mean).
At baseline, the mean scores were VAS 8.4, ODI 70%, BDI 28, EQ-5D 0.30, and SF-36 24. In general, maximum improvement was recorded at follow-up at 3 months (VAS 4.8, ODI 45%, BDI 15, EQ-5D 0.57, and SF-36 45). At last follow-up, scores were 5.6, 50%, 19, 0.57, and 40, respectively. Despite some regression, at last follow-up benefits were maintained and found to be statistically significant (P < .001) compared with baseline. Medication usage declined. SCS did not prevent disease spread to other limbs. Best results were achieved in stage I CRPS I, patients under 40 years of age, and those receiving SCS within 1 year of disease onset.
SCS improves pain, quality of life, and functional status over the long term and consequently merits early consideration in the treatment continuum.
复杂性区域疼痛综合征（CRPS）I 是一种衰弱性神经性疼痛障碍，其特征为灼痛和感觉过敏。脊髓刺激（SCS）对 CRPS I 的中期治疗有效，但长期疗效和改善功能状态的能力仍存在争议。
评估 SCS 长期改善疼痛、功能状态和生活质量的能力。
我们对 25 例患者进行了回顾性分析，平均随访时间为 88 个月。评估参数包括视觉模拟评分（VAS）、Oswestry 残疾指数（ODI）、贝克抑郁量表（BDI）、欧洲五维健康量表（EQ-5D）和健康调查简表 36 项（SF-36）以及药物消耗。评估在入组时、3 个月、12 个月和最后随访时（88 个月，平均）进行。
基线时，平均评分分别为 VAS 8.4、ODI 70%、BDI 28、EQ-5D 0.30 和 SF-36 24。一般来说，最大改善发生在 3 个月的随访时（VAS 4.8、ODI 45%、BDI 15、EQ-5D 0.57 和 SF-36 45）。在最后一次随访时，评分分别为 5.6、50%、19、0.57 和 40。尽管有所回退，但最后随访时的改善仍保持且与基线相比具有统计学意义（P <.001）。药物使用减少。SCS 未能阻止疾病向其他肢体扩散。I 期 CRPS I、40 岁以下患者和疾病发病后 1 年内接受 SCS 的患者获得最佳结果。
SCS 可长期改善疼痛、生活质量和功能状态，因此值得在治疗连续体中早期考虑。
