Department of Neurosurgery, Aalborg University Hospital, Denmark.
Dan Med J. 2022 Jun 15;69(7):A06210521.
Spinal cord stimulation (SCS) may be used to treat complex regional pain syndrome (CRPS) when other treatments fail. This study aimed to describe the effects of SCS for CRPS with known nerve injury, i.e. CRPS type 2 (CRPS-2), on pain reduction and opioid use.
Data from the outpatient clinic were retrieved from the Neurizon Neuromodulation Database. The patient records of 16 patients treated with SCS at Aalborg University Hospital, Denmark, who met the Budapest (2003) criteria for CRPS-2 and completed six- and 12+-month follow-up were included. In Excel, paired t-tests comparison was used to identify the effect of SCS in regard to the aspects mentioned above.
Eight of the 16 patients (50%) enrolled in this study had clinically significant pain reduction when treated with SCS. The average pain reduction for the whole cohort was more than 20%, going from average numerical rating scale 8.0 to 6.2 (p = 0.0006) and 6.0 (p = 0.0011) at the six-month and 12+-month follow-up, respectively. The use of opiods did not change significantly. Seven patients needed revision procedures and the system was explanted in one patient.
SCS may offer clinically relevant pain reduction in CRPS-2. However, in our cohort only half of the patients experienced a clinically significant response, and the costs and complications associated with SCS were considerable. Thus, further knowledge on patient selection and the SCS treatment mechanisms are warranted.
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not relevant.
脊髓刺激 (SCS) 可用于治疗其他治疗方法失败的复杂性区域疼痛综合征 (CRPS)。本研究旨在描述已知神经损伤的 CRPS（即 CRPS 型 2 [CRPS-2]）患者接受 SCS 治疗的效果，包括疼痛缓解和阿片类药物使用情况。
从丹麦奥尔堡大学医院的 Neurizon 神经调节数据库中检索门诊数据。该研究纳入了符合布达佩斯（2003 年）CRPS-2 标准且完成了 6 个月和 12 个月随访的 16 名患者。在 Excel 中，使用配对 t 检验比较来确定 SCS 在上述方面的效果。
本研究中，16 名患者中有 8 名（50%）接受 SCS 治疗后疼痛得到了明显缓解。整个队列的平均疼痛缓解率超过 20%，从平均数字评分量表 8.0 降至 6.2（p = 0.0006）和 6.0（p = 0.0011），分别在 6 个月和 12 个月随访时。阿片类药物的使用并未显著改变。7 名患者需要进行修正手术，1 名患者的系统被取出。
SCS 可能为 CRPS-2 提供具有临床意义的疼痛缓解。然而，在我们的队列中，只有一半的患者经历了有临床意义的反应，而且 SCS 相关的成本和并发症相当可观。因此，需要进一步了解患者选择和 SCS 治疗机制。
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不相关。
