Interventional Pain Management and Neuromodulation Practice, London, UK.
Neuromodulation. 2019 Jul;22(5):661-666. doi: 10.1111/ner.12803. Epub 2018 Sep 20.
To report a retrospective review of the longer-term results of peripheral neuromodulation in 12 patients with significant chronic sacroiliac joint pain who had previously failed multiple conservative and interventional pain therapies.
To allow for the assessment of meaningful longer-term outcome, implants for all 12 patients had been in place for a minimum of 18 months to a maximum of 36 months prior to the formal review.
Compared to the preimplantation baseline, the longer-term follow-up revealed a significant and sustained reduction in visual analog scale pain scores from 8.7T 1.1 to 1.1T 1.0 (p < 0.001), with a 75% reduction in analgesia requirement, and improvement in pain impact on daily function from 94.1% T 5.9% to 5.8% T 6.0% (p < 0.001).
This initial case series has highlighted that SIJ neuromodulation results in the reduction in pain intensity and improved functionality in patients who have already failed conventional medical management and interventional techniques, including RF denervation. These preliminary results merit a prospective randomized trial of peripheral neuromodulation.
报告 12 例先前接受多次保守和介入性疼痛治疗失败的慢性骶髂关节疼痛患者的外周神经调节长期疗效回顾性研究结果。
为了评估有意义的长期结果,所有 12 例患者的植入物在正式评估前至少放置了 18 个月,最长 36 个月。
与植入前基线相比,长期随访显示视觉模拟评分从 8.7T 1.1 显著且持续降至 1.1T 1.0(p<0.001),镇痛需求减少 75%,疼痛对日常功能的影响从 94.1% T 5.9%改善至 5.8% T 6.0%(p<0.001)。
这项初步的病例系列研究表明,对于已经接受常规药物治疗和介入技术(包括射频神经阻断)失败的患者,骶髂关节神经调节可降低疼痛强度并改善功能。这些初步结果值得进行外周神经调节的前瞻性随机试验。