Department of Neurosurgery, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.
Department of Neurosurgery, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.
World Neurosurg. 2020 Jun;138:77-82. doi: 10.1016/j.wneu.2020.02.075. Epub 2020 Feb 24.
Chronic abdominal pain is a debilitating condition known for its multifactorial nature. Outcomes with spinal cord stimulation (SCS) for abdominal pain syndromes are noticeably absent in the literature. To date, there have been no published reports of novel waveforms of SCS for management of chronic abdominal pain. We assessed the efficacy and durability of BurstDR SCS in reducing abdominal pain and analgesic consumption.
We performed a retrospective review of medical records from 3 patients with different etiologies of abdominal pain (postherniorrhaphy pain syndrome, Crohn disease, abdominal neuropathy). All patients underwent thoracic laminectomy for BurstDR SCS paddle lead and pulse generator placement after a successful trial stimulation period. Data were collected with a telephone survey after a minimum duration of >24 months following implantation. Pain scores were measured using a numeric rating scale. Two of 3 patients were entirely pain-free and reported Patient Global Impression of Change scores of 7 after a minimum follow-up of >24 months. While the third patient continued to have chronic as well as episodic abdominal pain, he was able to discontinue all narcotic pain medications and experienced a 33% decrease in frequency and 60% decrease in severity of monthly pain exacerbations. He reported satisfaction and a Patient Global Impression of Change of 6.
BurstDR SCS is a new programming modality, and long-term follow-up is necessary to determine its durability. Despite varying etiologies of abdominal pain, this series suggests BurstDR SCS sustained for >2 years might be effective as a treatment for abdominal pain syndromes. Future studies of SCS would benefit from standardized abdominal pain scores and high-powered studies using global patient registries.
慢性腹痛是一种具有多因素性质的使人虚弱的病症。脊髓刺激（SCS）治疗腹痛综合征的结果在文献中明显缺失。迄今为止，尚无关于 SCS 治疗慢性腹痛的新型波形的已发表报告。我们评估了 BurstDR SCS 减少腹痛和镇痛药消耗的疗效和持久性。
我们对 3 例不同病因腹痛患者（疝修补术后疼痛综合征、克罗恩病、腹部神经病）的病历进行了回顾性审查。所有患者均在成功的试验刺激期后接受胸椎椎板切除术以放置 BurstDR SCS 桨状导联和脉冲发生器。在植入后至少>24 个月的时间进行电话调查以收集数据。使用数字评分量表测量疼痛评分。3 例患者中有 2 例完全无痛，并在至少>24 个月的随访后报告患者整体变化印象评分为 7。虽然第 3 例患者仍有慢性和阵发性腹痛，但他能够停止所有阿片类止痛药，并经历每月疼痛加剧频率降低 33%和严重程度降低 60%。他报告了满意度和患者整体变化印象评分为 6。
BurstDR SCS 是一种新的编程模式，需要进行长期随访以确定其持久性。尽管腹痛的病因不同，但本系列研究表明，BurstDR SCS 持续>2 年可能是治疗腹痛综合征的有效方法。未来的 SCS 研究将受益于标准化的腹痛评分和使用全球患者登记处的高功率研究。
