Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands.
Neuromodulation. 2024 Aug;27(6):1055-1061. doi: 10.1016/j.neurom.2024.05.009. Epub 2024 Jul 11.
BACKGROUND: Spinal cord stimulation (SCS) has been reported to cause substantial pain relief and improved quality of life (QoL) in patients with persistent spinal pain syndrome (PSPS). Despite implantable pulse generator (IPG)-related inconveniences such as pain, shame, and discomfort affecting QoL and patient satisfaction, these are often neglected. Hence, the current study aims to determine the associations between patient satisfaction, IPG-related inconveniences, and preoperative counseling in a homogeneous group of patients with PSPS receiving SCS with IPG implantation in the gluteal or abdominal area. MATERIALS AND METHODS: Retrospective data on sample characteristics were gathered from the EPIC (electronic health record software) digital patient data base. Prospective data on patient satisfaction were obtained with a questionnaire that covered various topics such as shame, pain, disturbances in daily/intense activities, night rest and/or sleep, discomfort caused by clothing, and preoperative counseling. The exact location of the IPG and its scar were determined with photo analysis. Thereafter, the site of IPG placement was classified into separate quadrants within the gluteal and abdominal area. Patient satisfaction was defined as accepting the current location of the IPG without having the wish to undergo revision surgery. RESULTS: In total, 81 participants (50.9 ± 10 years) were included in this analysis, with patient satisfaction observed in 61 patients (75.3%). Among satisfied patients, more extensive preoperative counseling concerning IPG pain and discomfort was reported compared with patients who were not satisfied (p < 0.001). When comparing the two groups, significant differences were found in shame (8/81, 9.9%), IPG site pain (21/81, 25.9%), disturbance of activities (42/81, 51.9%), and clothing-related discomfort (42/81, 51.9%). CONCLUSIONS: On the basis of the current results, shared decision-making and comprehensive preoperative provision of information are recommended to optimize patient satisfaction regarding IPG pain, discomfort, and inconveniences. Although many patients experience these disadvantages despite successful SCS for pain related to PSPS, most of them accept this if they have received adequate preoperative information about expectations.
背景：脊髓刺激 (SCS) 已被报道可在持续性脊髓疼痛综合征 (PSPS) 患者中引起显著的疼痛缓解和生活质量 (QoL) 改善。尽管植入式脉冲发生器 (IPG) 相关的不便，如疼痛、羞耻和不适，会影响 QoL 和患者满意度，但这些往往被忽视。因此，本研究旨在确定在接受臀部或腹部 IPG 植入的 SCS 的 PSPS 同质患者群体中，患者满意度、与 IPG 相关的不便和术前咨询之间的关联。 材料和方法：从 EPIC（电子健康记录软件）数字患者数据库中收集样本特征的回顾性数据。使用涵盖羞耻感、疼痛、日常/剧烈活动障碍、夜间休息和/或睡眠、衣物不适和术前咨询等各种主题的问卷获得患者满意度的前瞻性数据。通过照片分析确定 IPG 的精确位置及其疤痕。然后，将 IPG 放置的部位分为臀部和腹部区域的单独象限。患者满意度定义为接受当前 IPG 位置，而不希望进行修订手术。 结果：共有 81 名参与者（50.9±10 岁）纳入本分析，61 名患者（75.3%）观察到患者满意度。在满意的患者中，与不满意的患者相比，报告了更多关于 IPG 疼痛和不适的广泛术前咨询（p<0.001）。当比较两组时，在羞耻感（8/81，9.9%）、IPG 部位疼痛（21/81，25.9%）、活动障碍（42/81，51.9%）和与衣物相关的不适（42/81，51.9%）方面存在显著差异。 结论：根据目前的结果，建议进行共同决策和全面的术前信息提供，以优化患者对 IPG 疼痛、不适和不便的满意度。尽管许多患者在接受成功的 SCS 治疗 PSPS 相关疼痛后会出现这些不利情况，但如果他们在术前获得了关于预期的充分信息，大多数患者会接受这些情况。
Pain Physician. 2016-5
Neuromodulation. 2012-2-2
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