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脊髓刺激治疗腰痛:一项系统评价

Spinal Cord Stimulation for Low Back Pain: A Systematic Review.

作者信息

Kaye Alan D, Archer Joseph R, Shah Shivam, Johnson Coplen D, Herron Lexa R, Brouillette Amy E, Armstrong Catherine J, Moore Peyton, Ahmadzadeh Shahab, Shekoohi Sahar, Chami Azem A

机构信息

Departments of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA.

Tulane University School of Medicine, New Orleans, LA, 70112, USA.

出版信息

Curr Pain Headache Rep. 2025 Jan 2;29(1):2. doi: 10.1007/s11916-024-01336-1.

Abstract

PURPOSE OF REVIEW

Chronic low back pain (LBP) is a prevalent and debilitating condition affecting millions worldwide. Among emerging interventions, spinal cord stimulation (SCS) has gained attention as a potential alternative for managing chronic LBP, particularly when alternative approaches fail to provide adequate relief.

RECENT FINDINGS

This systematic review focuses on both residual pain levels and ability to perform daily tasks after treatment with SCS. The present investigation includes a systematic search for studies from PubMed, Google Scholar, and Cochrane, and Embase. Sources were eligible for inclusion in the review if they were published from 2010 to present (May 1, 2024). 8 studies involving a total of 1,172 patients were evaluated. This systematic review demonstrated that SCS is superior to conventional medical management (CMM) for both short and long-term pain relief, functionality, psychological well-being, and opioid dependency. Furthermore, newer SCS approaches, such as high frequency (HF), differential target multiplexed (DTM), and multiphase SCS all demonstrated improved efficacy over traditional SCS for pain relief and functionality scores. Adverse event rates for all trials were low and represent the safety of SCS treatments. The present investigation provides insight into the capabilities of both traditional SCS and HF SCS, DTM SCS, and multiphase SCS as compared to baseline pain and functionality as well as conventional medical management (CMM). This review grants physicians a broader picture of the applicability of SCS, its safety profile, and the opportunities it offers for pain reduction and functionality over CMM.

摘要

综述目的

慢性腰痛(LBP)是一种普遍存在且使人衰弱的疾病,影响着全球数百万人。在新兴的干预措施中,脊髓刺激(SCS)作为一种治疗慢性腰痛的潜在替代方法受到了关注,尤其是当其他方法无法提供充分缓解时。

最新发现

本系统综述聚焦于SCS治疗后的残余疼痛水平和日常任务执行能力。本次调查包括对来自PubMed、谷歌学术、Cochrane和Embase的研究进行系统检索。如果研究发表于2010年至现在(2024年5月1日),则有资格纳入本综述。共评估了8项研究,涉及1172名患者。本系统综述表明,SCS在短期和长期疼痛缓解、功能、心理健康和阿片类药物依赖方面均优于传统药物治疗(CMM)。此外,更新的SCS方法,如高频(HF)、差异靶点多路复用(DTM)和多阶段SCS,在疼痛缓解和功能评分方面均显示出比传统SCS更高的疗效。所有试验的不良事件发生率较低,表明SCS治疗的安全性。本研究深入探讨了传统SCS以及HF SCS、DTM SCS和多阶段SCS与基线疼痛和功能以及传统药物治疗(CMM)相比的能力。本综述使医生对SCS的适用性、安全性概况以及与CMM相比其在减轻疼痛和改善功能方面提供的机会有更全面的了解。

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