Guld Emma E, Guld Katherine R, Tinney Tristan, Potesta Mark A, Patel Kamal
Pediatrics, Lake Erie College of Osteopathic Medicine, Bradenton, USA.
Emergency Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA.
Cureus. 2025 Apr 19;17(4):e82581. doi: 10.7759/cureus.82581. eCollection 2025 Apr.
Complex regional pain syndrome (CRPS) is a chronic pain condition causing severe pain, sensory disturbances, and functional impairments, disproportionately affecting adolescent females. Spinal cord stimulation (SCS) has emerged as a promising modality for managing refractory CRPS in pediatric patients, offering sustained pain relief and improved quality of life. This literature review evaluates SCS's efficacy, safety, and functional outcomes in this population, identifies evidence gaps, and provides recommendations for future research. Comprehensive searches were conducted in PubMed, EMBASE, Scopus, Medline, Web of Science, and the Cochrane Central Register of Controlled Trials, including randomized controlled trials, prospective studies, case series, and case reports, focused on pain relief, functional improvement, medication use, and quality of life. Findings indicate SCS significantly reduces pain, such as Visual Analog Scale scores dropping from 9.2 to 2.9; enhances function, including improved school attendance and physical activity; and decreases medication reliance by 50%-60%, including opioids, with benefits sustained over six months to eight years. Complications, such as cerebrospinal fluid leaks and infections, occur in 16.7% of cases, primarily during trial phases. However, small sample sizes of 7-15 patients, retrospective designs, and a lack of randomized controlled trials limit generalizability. Ethical challenges, including informed consent and device maintenance in growing children, further complicate adoption. Future research should prioritize large-scale, multicenter trials with extended follow-up to confirm long-term outcomes, optimize stimulation parameters, and explore cost-effectiveness. SCS's success suggests potential applicability to other pediatric pain syndromes, offering an opioid-sparing alternative that addresses both physical and psychosocial dimensions of CRPS, ultimately enhancing well-being in this vulnerable population.
复杂性区域疼痛综合征（CRPS）是一种慢性疼痛疾病，会导致严重疼痛、感觉障碍和功能受损，对青春期女性的影响尤为严重。脊髓刺激（SCS）已成为治疗儿科患者难治性CRPS的一种有前景的方法，可提供持续的疼痛缓解并改善生活质量。这篇文献综述评估了SCS在该人群中的疗效、安全性和功能结局，识别了证据空白，并为未来研究提供了建议。在PubMed、EMBASE、Scopus、Medline、Web of Science和Cochrane对照试验中央注册库中进行了全面检索，包括随机对照试验、前瞻性研究、病例系列和病例报告，重点关注疼痛缓解、功能改善、药物使用和生活质量。研究结果表明，SCS可显著减轻疼痛，如视觉模拟量表评分从9.2降至2.9；增强功能，包括提高上学出勤率和身体活动能力；减少50%-60%的药物依赖，包括阿片类药物，且益处可持续六个月至八年。并发症，如脑脊液漏和感染，在16.7%的病例中出现，主要发生在试验阶段。然而，样本量小（7-15名患者）、回顾性设计以及缺乏随机对照试验限制了结果的普遍性。伦理挑战，包括知情同意和成长中儿童的设备维护，使该方法的应用更加复杂。未来研究应优先进行大规模、多中心试验，并延长随访时间，以确认长期结局、优化刺激参数并探索成本效益。SCS的成功表明其可能适用于其他儿科疼痛综合征，提供了一种减少阿片类药物使用的替代方法，可解决CRPS的身体和心理社会层面问题，最终改善这一弱势群体的健康状况。
