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一项 10kHz 脊髓刺激系统治疗慢性盆腔疼痛的前瞻性、多中心临床试验。

A Prospective, Multi-Center, Clinical Trial of a 10-kHz Spinal Cord Stimulation System in the Treatment of Chronic Pelvic Pain.

机构信息

Alliance Spine and Pain Centers, Canton, Georgia, U.S.A.

Advanced Pain Management, Milwaukee, Wisconsin, U.S.A.

出版信息

Pain Pract. 2021 Jan;21(1):45-53. doi: 10.1111/papr.12932. Epub 2020 Aug 8.

Abstract

BACKGROUND

Chronic pelvic pain (CPP) is a debilitating condition that often leads to disability and does not respond to conventional treatments. This study was conducted to evaluate the effects of paresthesia-independent 10-kHz spinal cord stimulation (SCS) in subjects with CPP.

METHODS

This prospective, single-arm pilot study enrolled subjects with clinical diagnoses of CPP and mean pain scores of ≥ 5.0 cm on a 10-cm VAS. Subjects underwent trial stimulations with 10-kHz SCS, and those who had successful trial stimulations (≥40% pain relief) received permanently implanted devices and were followed for 12 months.

RESULTS

Of the 21 subjects who underwent the 10-kHz SCS trial, 17 were successful and 14 subjects received permanent implants. No neurological deficits were observed in any subjects and all adverse events (AEs) were resolved without sequelae during the study period. Over 12 months, mean VAS scores decreased by 72% from baseline, and 10 of 13 subjects (77%) were responders (≥50% pain relief). Pain remission (VAS score ≤ 3.0 cm) was reported by 8 of 13 subjects (62%), and mean pain scores on the short-form McGill Pain Questionnaire 2 decreased as well. Pain Disability Index scores declined by 29 points, and 85% of the subjects reported satisfaction.

CONCLUSIONS

Paresthesia-independent stimulation with 10-kHz SCS reduced pelvic pain in subjects with CPP and was not associated with any unexpected AEs. While larger, controlled studies are needed, results of this study suggest that this therapeutic modality could potentially treat patients with CPP while improving their quality of life.

摘要

背景

慢性盆腔疼痛(CPP)是一种使人衰弱的疾病,常导致残疾,且对常规治疗无反应。本研究旨在评估感觉缺失无关的 10kHz 脊髓刺激(SCS)对 CPP 患者的影响。

方法

这是一项前瞻性、单臂试点研究,纳入了临床诊断为 CPP 且 VAS 疼痛评分均值≥5.0cm 的患者。患者接受 10kHz SCS 试验刺激,如果试验刺激成功(≥40%的疼痛缓解),则植入永久性设备,并随访 12 个月。

结果

在接受 10kHz SCS 试验的 21 名患者中,17 名成功,14 名患者接受了永久性植入。所有患者均未出现神经功能缺损,研究期间所有不良事件(AE)均得到解决,无后遗症。12 个月时,VAS 评分平均较基线下降 72%,13 名患者中有 10 名(77%)为应答者(≥50%的疼痛缓解)。13 名患者中有 8 名(62%)报告疼痛缓解(VAS 评分≤3.0cm),简短麦吉尔疼痛问卷 2 的平均疼痛评分也有所下降。疼痛残疾指数评分下降 29 分,85%的患者表示满意。

结论

感觉缺失无关的 10kHz SCS 刺激降低了 CPP 患者的盆腔疼痛,且与任何意外 AE 无关。虽然需要更大规模的对照研究,但本研究结果表明,这种治疗方式可能在改善患者生活质量的同时,为 CPP 患者提供一种潜在的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac06/7818476/738fa889dbe7/PAPR-21-45-g001.jpg

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