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脊髓颈段刺激:综述。

Cervical Spinal Cord Stimulation: A Review.

机构信息

Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA.

Division of Pain Medicine, Mayo Clinic, Phoenix, AZ, USA.

出版信息

Curr Pain Headache Rep. 2024 Apr;28(4):239-249. doi: 10.1007/s11916-023-01200-8. Epub 2023 Dec 26.

Abstract

PURPOSE OF REVIEW

This literature review critically examines existing studies on cervical spinal cord stimulation (cSCS) for the treatment of chronic pain. The objective is to evaluate the current evidence, identify knowledge gaps, and collate data to inform clinical decision-making and suggest future research avenues. The review covers indications, contraindications, surgical and anesthetic approaches, trials, efficacy, and complications of cSCS.

RECENT FINDINGS

Recent advancements highlight the evolving role of cSCS in chronic pain management. New neuromodulation techniques involve optimal placement of leads based on the pain's innervation level, maximizing therapeutic outcomes. Contemporary studies underscore the broadening benefits of cSCS, including enhanced functional abilities and sleep quality. However, alongside these innovations come challenges; emerging data bring attention to complications such as hardware issues and infections. Significantly, modern research emphasizes the crucial role of accurate patient selection, factoring in prior therapy responses and comprehensive evaluations. cSCS emerges as a promising tool for chronic pain management, with benefits beyond mere pain relief. As surgical techniques, patient selection criteria, and postoperative care refine, the potential of cSCS expands to benefit a broader patient demographic. However, further comprehensive research is necessary to enhance its application, validate its role earlier in treatment, and ultimately ameliorate the lives of those with chronic pain.

摘要

目的综述

本文对颈椎脊髓刺激(cSCS)治疗慢性疼痛的现有研究进行了批判性评估。目的是评估当前证据,确定知识空白,并整理数据,为临床决策提供信息,并提出未来的研究方向。综述涵盖了 cSCS 的适应证、禁忌证、手术和麻醉方法、试验、疗效和并发症。

最近的发现

最近的进展强调了 cSCS 在慢性疼痛管理中的作用不断演变。新的神经调节技术涉及根据疼痛的神经支配水平优化导线的放置,以最大限度地提高治疗效果。当代研究强调了 cSCS 广泛获益,包括增强功能能力和改善睡眠质量。然而,这些创新伴随着挑战;新出现的数据引起了人们对硬件问题和感染等并发症的关注。重要的是,现代研究强调了准确选择患者的关键作用,考虑到先前治疗反应和全面评估。cSCS 作为慢性疼痛管理的一种有前途的工具,其益处不仅仅在于缓解疼痛。随着手术技术、患者选择标准和术后护理的完善,cSCS 的潜力不断扩大,造福更广泛的患者群体。然而,仍需要进行更全面的研究,以增强其应用,更早地验证其在治疗中的作用,并最终改善慢性疼痛患者的生活。

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