Puylaert Martine, Nijs Lynn, Buyse Klaas, Vissers Kris, Vanelderen Pascal, Nagels Margot, Daenekindt Thomas, Weyns Frank, Mesotten Dieter, Van Zundert Jan, Van Boxem Koen
Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium; Department of Anesthesiology and Pain Management, University Medical Centre Maastricht, Maastricht, The Netherlands.
KU Leuven, Department of Public Health and Primary Care, Biomedical Quality Assurance Research Unit, Leuven, Belgium.
Neuromodulation. 2023 Oct;26(7):1433-1440. doi: 10.1016/j.neurom.2022.03.006. Epub 2022 May 14.
This is a retrospective, observational study.
Spinal cord stimulation (SCS) has found its application in chronic pain treatment, with failed back surgery syndrome (FBSS) as one of the most important indications. However, to date, little is known about the long-term effectiveness of the treatment. The aim of this study is to analyze retrospectively the long-term outcomes of SCS treatment in a single multidisciplinary pain center on predominant radicular pain, using devices of a single manufacturer.
Patient data on overall patient satisfaction, pain intensity, and adverse events were retrospectively collected in our clinical practice between January 1998 and January 2018, for 191 patients who received a permanent SCS implant. Secondary health measures included the influence of opioid and nicotine use on pain reduction after therapy.
The trial-to-implant ratio was 93.6%. At a mean follow-up of 10.6 years, 78.5% of the patients were satisfied with the treatment outcome, with a significant pain reduction of an average three points on a Numeric Rating Scale. Opioid and nicotine usage did not have a significant link with the pain reduction one year after the treatment. Furthermore, devices had an average battery lifespan of 8.4 years. A total of 248 revisions were recorded. A total of 24 patients (11.7%) acquired an infection; 7 of 204 patients had an infection during the trial period, 2 of 191 patients had an infection in the first postoperative year, and 15 of 191 patients had an infection after the first year. The average time to infection, if not in the first year, was 10.1 years.
A successful long-term outcome regarding pain relief in patients with predominant radicular pain due to FBSS is established with SCS therapy.
这是一项回顾性观察研究。
脊髓刺激（SCS）已应用于慢性疼痛治疗，失败的脊柱手术综合征（FBSS）是最重要的适应症之一。然而，迄今为止，对于该治疗的长期有效性知之甚少。本研究的目的是回顾性分析在单一多学科疼痛中心使用单一制造商的设备对以根性疼痛为主的患者进行SCS治疗的长期结果。
回顾性收集了1998年1月至2018年1月期间在我们临床实践中191例接受永久性SCS植入患者的总体患者满意度、疼痛强度和不良事件的患者数据。次要健康指标包括阿片类药物和尼古丁使用对治疗后疼痛减轻的影响。
试验与植入比例为93.6%。平均随访10.6年时，78.5%的患者对治疗结果满意，数字评分量表上疼痛平均显著减轻3分。治疗一年后，阿片类药物和尼古丁使用与疼痛减轻没有显著关联。此外，设备平均电池寿命为8.4年。共记录了248次翻修。共有24例患者（11.7%）发生感染；204例患者中有7例在试验期发生感染，191例患者中有2例在术后第一年发生感染，191例患者中有15例在第一年后发生感染。如果不是在第一年发生感染，平均感染时间为10.1年。
SCS治疗为因FBSS导致以根性疼痛为主的患者带来了成功的长期疼痛缓解效果。
