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慢性盆腔疼痛患者的背根神经节刺激:患者体验和长期结果的回顾性研究

Dorsal root ganglion stimulation for patients with chronic pelvic pain: A retrospective review of patient experiences and long-term outcomes.

作者信息

Burns Stacey L, Majdak Petra, Adler Alexandra R, Jo Celine, Chiang Michael C, Yong Robert Jason, Barreveld Antje M

机构信息

Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.

Lowell General Hospital, 2 Hospital Dr 2nd Floor, Lowell, MA, 01852, USA.

出版信息

Interv Pain Med. 2024 Mar 10;3(1):100397. doi: 10.1016/j.inpm.2024.100397. eCollection 2024 Mar.

Abstract

INTRODUCTION

Chronic pelvic pain (CPP) is a refractory condition that has physical, emotional, and financial impacts on patients. Dorsal root ganglion stimulation (DRGS) is a promising interventional modality for patients with refractory CPP, however studies of long-term outcomes are limited. We aim to present the results from a retrospective review of 31 patients with CPP treated using DRGS.

MATERIALS AND METHODS

IRB approval was obtained. A retrospective chart review was conducted, including 31 patients who underwent a DRGS trial between 2017 and 2022 at two academic centers. Pain history, trial/implant lead configuration, complications/revisions, pain scores, functional goals, and medication use were recorded.

RESULTS

Thirty-one patients with CPP underwent a 7-10 day DRGS trial between 2017 and 2022. Of the 31 patients, 21 (68%, CI 50-81%) had a successful trial, defined as >50% reported pain relief. Twenty patients underwent DRGS implantation. Average follow-up was 28.2 ± 17.3 months. Nine patients (45%) required revision surgery for lead migration or fracture. Thirteen patients remain implanted with an average reported percent relief of 55 ± 15%. Seven patients were explanted (35%), with an average time to explant of 12.5 ± 3 months.

CONCLUSIONS

This study presents one of the largest groups of patients with DRGS for the treatment of CPP. The results highlight the variable experiences of patients after DRGS trial/implant. We report on the incidence of lead migration and fracture, sparingly described in the literature. Larger, prospective studies are needed to elucidate which patients with CPP may benefit most from DRGS, and to better understand the incidence and implications of complications.

摘要

引言

慢性盆腔疼痛(CPP)是一种难治性疾病,会对患者的身体、情感和经济造成影响。背根神经节刺激术(DRGS)对于难治性CPP患者是一种有前景的介入治疗方式,然而关于其长期疗效的研究有限。我们旨在呈现对31例接受DRGS治疗的CPP患者进行回顾性分析的结果。

材料与方法

获得了机构审查委员会(IRB)的批准。进行了一项回顾性病历审查,纳入了2017年至2022年间在两个学术中心接受DRGS试验的31例患者。记录了疼痛病史、试验/植入电极配置、并发症/翻修情况、疼痛评分、功能目标和药物使用情况。

结果

31例CPP患者在2017年至2022年间接受了为期7 - 10天的DRGS试验。在这31例患者中,21例(68%,置信区间50 - 81%)试验成功,定义为报告疼痛缓解>50%。20例患者接受了DRGS植入。平均随访时间为28.2±17.3个月。9例患者(45%)因电极移位或断裂需要进行翻修手术。13例患者仍保留植入装置,报告的平均缓解百分比为55±15%。7例患者(35%)移除了装置,平均移除时间为12.5±3个月。

结论

本研究呈现了接受DRGS治疗CPP的最大患者群体之一。结果突出了患者在DRGS试验/植入后的不同经历。我们报告了电极移位和断裂的发生率,这在文献中很少被描述。需要开展更大规模的前瞻性研究,以阐明哪些CPP患者可能从DRGS中获益最多,并更好地了解并发症的发生率及影响。

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