Meglio M, Cioni B, Prezioso A, Talamonti G
Instituto di Neurochirurgia, Università Cattolica, Roma, Italy.
Pacing Clin Electrophysiol. 1989 Apr;12(4 Pt 2):709-12. doi: 10.1111/j.1540-8159.1989.tb02720.x.
Spinal cord stimulation is considered to be ineffective in relieving deafferentation pain. We have retrospectively analyzed the results obtained in a series of 41 patients. Sixteen suffered from pain associated with an incomplete traumatic spinal lesion, 15 from a posttherapeutic neuralgia, and 10 from pain due to root and/or nerve damage. At the end of the test period, 43.7% of the patients with paraplegic pain, (40% of those with peripheral deafferentation pain and 66.6% of the ones with postherapeutic neuralgia), reported satisfactory pain relief and were connected to a chronic stimulation system. At mean follow-up (15 months), only 20% of the patients of the first two groups reported sufficient pain relief. In the postherapeutic group the figure of responders was unchanged. The mean analgesia achieved was 70%. From this analysis we conclude that the results achieved in the postherapeutic pain patients, although positive in only 66% of them, are remarkably stable with time. Therefore, we recommend a percutaneous test trial of SCS in every case of postherapeutic pain resistant to medical treatment.
脊髓刺激被认为对缓解去传入性疼痛无效。我们回顾性分析了41例患者的治疗结果。其中16例患有与不完全性创伤性脊髓损伤相关的疼痛，15例患有治疗后神经痛，10例患有因神经根和/或神经损伤引起的疼痛。在测试期结束时，43.7%的截瘫性疼痛患者（40%的外周去传入性疼痛患者和66.6%的治疗后神经痛患者）报告疼痛缓解满意，并连接到慢性刺激系统。平均随访（15个月）时，前两组中只有20%的患者报告疼痛缓解充分。在治疗后组中，有反应者的比例没有变化。平均镇痛效果为70%。从该分析中我们得出结论，治疗后疼痛患者所取得的结果，尽管只有66%的患者结果呈阳性，但随着时间推移非常稳定。因此，我们建议对每一例药物治疗无效的治疗后疼痛患者进行脊髓刺激的经皮试验性治疗。
