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用于治疗慢性顽固性上肢疼痛的差异靶点多重脊髓刺激:一项前瞻性多中心研究的12个月结果

Differential Target Multiplexed Spinal Cord Stimulation for the Treatment of Chronic Intractable Upper Limb Pain: 12-Month Results From a Prospective, Multicenter Study.

作者信息

White Thomas, Justiz Rafael, Fishman Michael, Schultz David, Calodney Aaron, Cordner Harold, Almonte Wilson, Millet Yoann, Wu Kenneth, Gekht Gennady, Will Andrew, Kim Philip, Bundschu Richard, Sirianni Justin, El-Naggar Amr, Gupta Mayank, Park Wesley, Cedeño David L, Vallejo Ricardo

机构信息

Procura Pain and Spine, Shenandoah, TX, USA.

Oklahoma Pain Physicians, Oklahoma City, OK, USA.

出版信息

Neuromodulation. 2024 Dec;27(8):1441-1448. doi: 10.1016/j.neurom.2024.06.497. Epub 2024 Jul 25.

DOI:10.1016/j.neurom.2024.06.497
PMID:39046394
Abstract

OBJECTIVES

This prospective, open-label, single-arm, multicenter study evaluated the use of differential target multiplexed (DTM) spinal cord stimulation (SCS) therapy for chronic upper limb pain (ULP).

MATERIALS AND METHODS

A total of 58 candidates for SCS who had chronic ULP were enrolled at 11 sites in the USA. The safety and effectiveness of DTM SCS for treating chronic intractable ULP were evaluated over 12 months. The primary end point was the percentage of responders (≥50% ULP relief versus baseline) to treatment at three months after device activation. This study also evaluated the extent of disability, patient satisfaction, and patient global impression of change with DTM SCS therapy.

RESULTS

The mean baseline pain score (10-cm visual analog scale [VAS-10]) for ULP was 7.2 cm, with a mean age of 56 years and mean ULP duration of ten years; 47 subjects were assessed at the primary end point. The percentage of ULP responders was 92% at three months, which was consistent at six (91%) and 12 months (86%). Significant ULP relief (81% reduction in VAS-10) was observed at the primary end point and sustained throughout the study duration. Significant improvements in disability in addition to high levels (>95%) of satisfaction and feelings of improvement were reported. Frequency of study-related anticipated adverse events was in line with expectations of SCS therapy.

CONCLUSION

In this patient population with difficult-to-treat conditions with limited clinical evidence of the effectiveness of SCS, subjects reported significant reduction in chronic ULP in response to treatment with DTM SCS.

摘要

目的

本前瞻性、开放标签、单臂、多中心研究评估了差异靶点多路复用(DTM)脊髓刺激(SCS)疗法用于慢性上肢疼痛(ULP)的情况。

材料与方法

共有58例患有慢性ULP的SCS候选患者在美国的11个地点入组。对DTM SCS治疗慢性难治性ULP的安全性和有效性进行了为期12个月的评估。主要终点是设备激活后三个月时治疗反应者(与基线相比上肢疼痛缓解≥50%)的百分比。本研究还评估了DTM SCS疗法对残疾程度、患者满意度以及患者对变化的总体印象。

结果

ULP的平均基线疼痛评分(10厘米视觉模拟量表[VAS-10])为7.2厘米,平均年龄为56岁,ULP平均病程为10年;47名受试者在主要终点进行了评估。三个月时上肢疼痛反应者的百分比为92%,六个月(91%)和十二个月(86%)时保持一致。在主要终点观察到上肢疼痛显著缓解(VAS-10降低81%),并在整个研究期间持续。报告显示除了高水平(>95%)的满意度和改善感觉外,残疾程度也有显著改善。与研究相关的预期不良事件发生率符合SCS疗法的预期。

结论

在这种治疗困难且SCS有效性临床证据有限的患者群体中,受试者报告称,DTM SCS治疗使慢性上肢疼痛显著减轻。

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