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一项关于经皮周围神经刺激术治疗慢性肩部疼痛的单中心回顾性病历审查。

A single-center retrospective chart review of percutaneous PNS for treatment of chronic shoulder pain.

作者信息

Gutierrez Genaro J, Mehta Pankaj, Mouch Trey, Puri Shawn, Caylor Jacob R, Huffman William J, Crosby Nathan D, Boggs Joseph W

机构信息

Pain Specialists of America, 4100 Duval Road , Building 3, Suite 200, Austin, TX, 78759, USA.

SPR Therapeutics, 22901 Millcreek Blvd, Suite 500, Cleveland, OH, 44122, USA.

出版信息

Interv Pain Med. 2024 Jul 11;3(3):100419. doi: 10.1016/j.inpm.2024.100419. eCollection 2024 Sep.

Abstract

OBJECTIVE

The present IRB-approved retrospective chart review describes the use of a 60-day PNS treatment for shoulder pain at a single center in 60 total consecutive patients.

BACKGROUND

Chronic shoulder pain affects an increasing number of patients per year and is especially prevalent in elderly populations. Percutaneous peripheral nerve stimulation (PNS) treatment targeting the nerves of the shoulder has been shown to reduce pain in prospective clinical studies and in analysis of real-world data.

METHODS

Data were extracted from the electronic medical records of patients who had previously undergone percutaneous PNS treatment for chronic shoulder pain. Demographic data and treatment characteristics were summarized alongside treatment outcomes.

RESULTS

Overall, 84 % (49/58) of patients reported substantial (≥50 %) pain relief at the end-of-treatment. The records for 2 patients did not include patient-reported percent pain relief. The average indwelling period for leads (i.e., treatment period) was 57 days. Findings on treatment effectiveness were consistent when the patient population was stratified by cause of pain, duration living with pain, and presence of pain-modifying comorbidities. Stimulation paradigms were identified and categorized by the nerve target and stimulation frequency (e.g., motor stimulation, sensory stimulation, or bimodal stimulation).

CONCLUSIONS

These results indicate percutaneous PNS is an effective treatment for patients with various shoulder pain histories, and while all stimulation paradigms were effective at reducing pain, patients who received bimodal PNS reported the greatest pain relief. Key limitations of the study included heterogeneous shoulder pain etiologies among patients and sparse availability of long-term follow-up data. These data support existing real-world and prospective clinical evidence on the efficacy of 60-day PNS treatment at treating chronic pain and provide valuable insights into its use in clinical practice.

摘要

目的

本项经机构审查委员会(IRB)批准的回顾性病历审查描述了在一个中心对60例连续患者使用60天的经皮外周神经刺激(PNS)治疗肩部疼痛的情况。

背景

慢性肩部疼痛每年影响的患者数量不断增加,在老年人群中尤为普遍。针对肩部神经的经皮外周神经刺激(PNS)治疗在前瞻性临床研究和真实世界数据分析中已显示可减轻疼痛。

方法

从先前接受过经皮PNS治疗慢性肩部疼痛的患者的电子病历中提取数据。人口统计学数据和治疗特征与治疗结果一并汇总。

结果

总体而言,84%(49/58)的患者在治疗结束时报告疼痛大幅减轻(≥50%)。2例患者的记录未包括患者报告的疼痛减轻百分比。电极的平均留置期(即治疗期)为57天。当按疼痛原因、疼痛持续时间和是否存在影响疼痛的合并症对患者群体进行分层时,治疗效果的发现是一致的。根据神经靶点和刺激频率(如运动刺激、感觉刺激或双模式刺激)确定并分类刺激模式。

结论

这些结果表明,经皮PNS对有各种肩部疼痛病史的患者是一种有效的治疗方法,虽然所有刺激模式都能有效减轻疼痛,但接受双模式PNS治疗的患者疼痛缓解程度最大。该研究的主要局限性包括患者肩部疼痛病因的异质性以及长期随访数据的可获得性不足。这些数据支持了关于60天PNS治疗慢性疼痛疗效的现有真实世界和前瞻性临床证据,并为其在临床实践中的应用提供了有价值的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3160/11536284/8d2035a49fc3/gr1.jpg

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