现代神经刺激方式的荟萃分析——神经刺激技术的进展
A meta-analysis of modern neuro-stimulation modalities-Advances in neuro-stimulation techniques.
作者信息
Aleid Abdulsalam Mohammed, Aldanyowi Saud Nayef, Aleid Ayat, Albazli Khaled, Fatani Ghadeer Mohammad, Almalki Sami
机构信息
Department of Surgery, King Faisal University, Al-Ahsa, Saudi Arabia.
Department of Surgery, Medical College, King Faisal University, Al-Ahsa, Saudi Arabia.
出版信息
Surg Neurol Int. 2025 Apr 25;16:146. doi: 10.25259/SNI_656_2024. eCollection 2025.
BACKGROUND
Chronic pain is a debilitating condition that affects about 3% of the population globally. Conventionally, pharmacologic approaches, psychotherapy, and surgery have been used in the management of chronic refractory pain. However, over the past decades, advances in neurotechnology have enabled modern novel techniques of neurostimulation, such as spinal cord stimulation (SCS) and dorsal root ganglion (DRG), to be used in the management of chronic neuropathic pain that does not respond to conventional management. This review, therefore, aims to establish the efficacy of these two novel technologies in the management of chronic neuropathic pain compared to conventional medical management (CMM) techniques.
METHODS
A systematic search was conducted on three electronic databases, PubMed, Science Direct, and CENTRAL, for all relevant articles to the study topic. After a detailed review by two independent reviewers, only the articles that met the inclusion criteria were included. The Review Manager 5.4 software was utilized to conduct a meta-analysis of the outcomes of pain reduction.
RESULTS
Our online search yielded 345 articles; however, only eight studies were included in the analysis according to our inclusion criteria. The results from our pooled analysis indicated that SCS and dorsal root stimulation both resulted in a significant reduction in the rating of chronic pain mean difference (MD) (-4.73; 95% confidence interval [CI] [-4.76, -4.71] < 0.00001) and MD (-1.09; 95% CI [-1.29, -0.90] < 0.00001), respectively. Similarly, for the studies that reported percentage change in pain rating, the pooled analysis showed that SCS resulted in a higher percentage reduction in pain rating compared to CMM MD (69.47; 95% CI [64.31, 74.64] < 0.00001).
CONCLUSION
Based on the results of our analysis, we conclude that advances in neurostimulation techniques, such as SCS and DRG stimulation, have resulted in better management of chronic neuropathic pain compared to conventional pain management techniques.
背景
慢性疼痛是一种使人衰弱的疾病，全球约3%的人口受其影响。传统上，药物治疗、心理治疗和手术已被用于慢性难治性疼痛的管理。然而，在过去几十年中，神经技术的进步使现代新型神经刺激技术，如脊髓刺激（SCS）和背根神经节（DRG），能够用于治疗对传统治疗无反应的慢性神经性疼痛。因此，本综述旨在确定与传统医学管理（CMM）技术相比，这两种新技术在慢性神经性疼痛管理中的疗效。
方法
在三个电子数据库PubMed、Science Direct和CENTRAL上对与该研究主题相关的所有文章进行系统检索。经过两名独立审稿人的详细审查，仅纳入符合纳入标准的文章。使用Review Manager 5.4软件对疼痛减轻结果进行荟萃分析。
结果
我们的在线搜索产生了345篇文章；然而，根据我们的纳入标准，只有八项研究被纳入分析。我们汇总分析的结果表明，SCS和背根刺激均导致慢性疼痛平均差异（MD）评分显著降低（分别为-4.73；95%置信区间[CI][-4.76，-4.71]<0.00001）和MD（-1.09；95%CI[-1.29，-0.90]<0.00001）。同样，对于报告疼痛评分百分比变化的研究，汇总分析表明，与CMM MD相比，SCS导致疼痛评分降低的百分比更高（69.47；95%CI[64.31，74.64]<0.00001）。
结论
根据我们的分析结果，我们得出结论，与传统疼痛管理技术相比，神经刺激技术（如SCS和DRG刺激）的进步导致了对慢性神经性疼痛的更好管理。
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