Kamihara Masahito, Nakano Susumu, Fukunaga Tomoe, Ikeda Kazuyo, Tsunetoh Takashi, Tanada Daisuke, Murakawa Kazushige
Department of Pain Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
Neuromodulation. 2014 Jun;17(4):340-4; discussion 345. doi: 10.1111/ner.12092. Epub 2013 Aug 6.
Spinal cord stimulation (SCS) is expected to have analgesic effects in patients with neuropathic pain, ischemic pain, or mixed pain. The type of leg pain caused by lumbar spinal stenosis (LSS) is considered as mixed pain, which is expected to respond to SCS. However, there is no established view on the usefulness of SCS in the management of this type of pain. Therefore, we aimed at evaluating the efficacy of SCS against leg pain associated with LSS.
Data were collected retrospectively for the period from January 2003 to December 2011 from 91 patients with LSS-associated leg pain enrolled to the SCS trial. SCS implantation was performed in patients who responded to the trial and desired to receive this therapy.
The response rate (percentage of patients showing 50% or greater alleviation of pain) in the trial was 65% (59/91 patients). SCS implantation was performed on 41 patients. The percentage of patients who showed a good response (definition is SCS continued for one year or longer after implantation) was 95% (39/41).
SCS seemed to be effective against leg pain associated with LSS. Thus, SCS should be actively adopted in indicated patients as a method of treatment intermediate between conservative therapy and surgical therapy.
脊髓刺激(SCS)有望对神经性疼痛、缺血性疼痛或混合性疼痛患者产生镇痛效果。腰椎管狭窄症(LSS)引起的腿痛类型被视为混合性疼痛,预计对SCS有反应。然而,关于SCS在治疗此类疼痛中的有效性尚无定论。因此,我们旨在评估SCS治疗与LSS相关腿痛的疗效。
回顾性收集2003年1月至2011年12月期间纳入SCS试验的91例与LSS相关腿痛患者的数据。对试验有反应且希望接受该治疗的患者进行SCS植入。
试验中的缓解率(疼痛减轻50%或更多的患者百分比)为65%(59/91例患者)。41例患者进行了SCS植入。显示良好反应(定义为植入后SCS持续一年或更长时间)的患者百分比为95%(39/41)。
SCS似乎对与LSS相关的腿痛有效。因此,对于适应症患者,应积极采用SCS作为介于保守治疗和手术治疗之间的一种治疗方法。