Department of Neurosurgery, Far Eastern Federal University, Medical Center, Vladivostok, Russia.
Department of Fundamental Medicine, Far Eastern Federal University, School of Biomedicine, Vladivostok, Russia.
Int Rev Neurobiol. 2023;172:79-99. doi: 10.1016/bs.irn.2023.03.003. Epub 2023 Apr 7.
Spasticity develops in 80% of spinal cord injury cases and negatively affects the patents' quality of life. The most common method of surgical treatment for severe spasticity is a long-term intrathecal baclofen therapy (ITB). Long-term spinal cord stimulation is another possible treatment technique. This paper aims to evaluate the changes in quality of life for patients with spasticity who have been treated with neuromodulation (SCS or ITB) in 12 months after the surgery, as well to compare the changes in quality of life for patients who have been treated with spinal cord stimulation and those who received long-term intrathecal baclofen therapy.
The influence of spasticity, experienced by the patients with a spinal cord injury, on their quality of life was analyzed before the surgery and 12 months after it. The severity of the spinal cord damage was determined with the scale of the American Spinal Injury Association (ASIA); spasticity was evaluated with the modified Ashworth scale, Penn Spasm Frequency Scale; pain levels were determined with visual analogue scale (VAS), anxiety and depression levels - with HADS. Functional activity of the patients was evaluated with the help of the Functional Independence Measure (FIM).
The treatment results for 33 patients (25 men and 8 women), aged from 18 to 62, are presented. After the trial stimulation, the patients were randomly assigned to either SCS or ITB group (18 and 15 people respectively). The decrease of spasticity in both experimental groups caused lower levels of pain, less functional dependency on other people, lower stress and depression rates and, as a consequence, better quality of life and social adaptation. The obtained results for SCS and ITB groups are statistically similar.
痉挛在 80%的脊髓损伤病例中发展，并对患者的生活质量产生负面影响。治疗严重痉挛最常见的手术方法是长期鞘内巴氯芬治疗（ITB）。长期脊髓刺激是另一种可能的治疗技术。本文旨在评估接受神经调节（SCS 或 ITB）治疗的痉挛患者在手术后 12 个月的生活质量变化，并比较接受脊髓刺激治疗和长期鞘内巴氯芬治疗的患者的生活质量变化。
分析了脊髓损伤患者的痉挛对其生活质量的影响，分别在手术前和手术后 12 个月进行。脊髓损伤的严重程度用美国脊髓损伤协会（ASIA）量表确定；痉挛用改良 Ashworth 量表、宾夕法尼亚痉挛频率量表评估；疼痛程度用视觉模拟量表（VAS）确定，焦虑和抑郁程度用 HADS 确定。患者的功能活动用功能独立性测量（FIM）评估。
报告了 33 名患者（25 名男性和 8 名女性）的治疗结果，年龄在 18 至 62 岁之间。在试验刺激后，患者被随机分配到 SCS 或 ITB 组（分别为 18 人和 15 人）。两组的痉挛减轻导致疼痛水平降低、对他人的功能依赖性降低、压力和抑郁率降低，从而导致生活质量和社会适应能力提高。SCS 和 ITB 组的结果具有统计学相似性。
