Della Pepa Giuseppe Maria, Fukaya Chikashi, La Rocca Giuseppe, Zhong Jun, Visocchi Massimiliano
Institute of Neurosurgery, Catholic University of Rome, Rome, Italy.
Stereotact Funct Neurosurg. 2013;91(5):275-87. doi: 10.1159/000348271. Epub 2013 Jun 22.
Vegetative state (VS) is a complex condition that represents a challenging frontier for medicine and neuroscience research. Nowadays there is no scientifically validated treatment for VS patients, and their chronic long-term assistance is very demanding for healthcare systems worldwide.
The present paper is a systematic review of the role of spinal cord stimulation (SCS) as a treatment of patients with VS.
Published literature on this topic was analyzed systematically. Clinical and epidemiological characteristics of VS, present therapeutic options and social costs of VS were also evaluated.
Only 10 papers have been published since 1988, and overall 308 VS patients have been treated with SCS worldwide; 51.6% displayed a clinical improvement and an amelioration of the environmental interaction. These effects are probably mediated by the stimulation of the reticular formation-thalamus-cortex pathway and by cerebral blood flow augmentation induced by SCS.
The experience on this topic is still very limited, and on this basis it is still hard to make any rigorous assessment. However, the most recent experiments represent significant progress in the research on this topic and display SCS as a possible therapeutic tool in the treatment of VS.
植物状态（VS）是一种复杂的状况，是医学和神经科学研究面临的具有挑战性的前沿领域。目前，对于VS患者尚无经过科学验证的治疗方法，他们的长期慢性护理对全球医疗系统来说要求极高。
本文是对脊髓刺激（SCS）作为VS患者治疗方法的作用的系统评价。
系统分析了关于该主题的已发表文献。还评估了VS的临床和流行病学特征、当前的治疗选择以及VS的社会成本。
自1988年以来仅发表了10篇论文，全球共有308例VS患者接受了SCS治疗；51.6%的患者显示出临床改善以及与环境互动的改善。这些效应可能是由网状结构 - 丘脑 - 皮质通路的刺激以及SCS诱导的脑血流量增加介导的。
关于该主题的经验仍然非常有限，在此基础上仍然难以进行任何严格的评估。然而，最近的实验代表了该主题研究的重大进展，并显示SCS作为治疗VS的一种可能的治疗工具。
