一种针对既往两段式脊柱手术且脊髓刺激硬膜外入路受阻患者的神经刺激的独特方法：病例系列研究。
A unique approach to neurostimulation in patients with previous two-segment spine surgery and obstruction of epidural access for spinal cord stimulation: a case series.
机构信息
Carolinas Center for Advanced Management of Pain, NC-SC, Spartanburg, SC 29306, USA.
出版信息
Neuromodulation. 2012 May-Jun;15(3):204-9; discussion 209. doi: 10.1111/j.1525-1403.2011.00397.x. Epub 2011 Oct 25.
INTRODUCTION
Patients with extensive surgery in the lumbar and thoracic spine are often not considered for neurostimulation due to the inability to perform a conventional spinal cord stimulation (SCS) trial. We are presenting six such patients in which spinal-peripheral neurostimulation (SPN) was used via a caudal approach.
METHODS
Six patients with intractable low back and leg pain following extensive lumbar and thoracic surgeries, up to at least the T10 level, underwent a stimulation trial with one caudal lead and one subcutaneous lead in order to achieve SPN.
RESULTS
In five cases, the trial was successful with coverage of the pain area and at least satisfactory pain relief. All six patients were implanted with a paddle lead(s) and a subcutaneous lead using SPN with good pain control.
CONCLUSION
SPN with a caudal lead appears to be a viable option for SCS trial in patients with no possibilities for conventional trial lead placement.
简介
由于无法进行常规脊髓刺激 (SCS) 试验，通常不考虑接受广泛腰椎和胸椎手术的患者进行神经刺激。我们将介绍六位采用经骶尾部入路进行脊髓-外周神经刺激 (SPN) 的此类患者。
方法
六位在接受广泛的腰椎和胸椎手术（至少达到 T10 水平）后出现顽固性腰痛和腿痛的患者，通过一根骶尾部导联和一根皮下导联进行刺激试验，以实现 SPN。
结果
在五例中，试验成功覆盖了疼痛区域，并至少获得了令人满意的疼痛缓解。六位患者均使用 SPN 植入了一个盘状导联和一根皮下导联，实现了良好的疼痛控制。
结论
对于无法进行常规试验导联放置的患者，骶尾部导联的 SPN 似乎是 SCS 试验的可行选择。
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