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慢性疼痛患者脊髓刺激成功的预测因素:一项回顾性队列研究。

Predictive Factors of Successful Spinal Cord Stimulation in Patients with Chronic Pain: A Retrospective Cohort Study.

作者信息

Yoo Yongjae, Roh Hyungsang, Moon Jee Youn, Choi Eun Joo, Nahm Francis Sahngun, Lee Pyung Bok

机构信息

Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea.

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea.

出版信息

Brain Sci. 2025 Jun 6;15(6):614. doi: 10.3390/brainsci15060614.

Abstract

Spinal cord stimulation (SCS) is applied for managing chronic intractable pain, but the factors predicting its effectiveness have not been extensively researched. Our study aimed to identify clinical variables that can predict the outcome of SCS. The electronic medical records of patients who received SCS for chronic intractable pain at two large tertiary teaching institutions in South Korea from 2008 to 2022 were reviewed. A successful outcome was characterized by attaining at least a 50% reduction in pain on the numerical rating scale (NRS) assessed at 6 months. Multivariable analysis was used to investigate the correlation between outcomes of SCS and clinical variables. Of the 213 patients, 108 (50.7%) experienced successful outcomes at 6 months after SCS implantation. At 6 months, both the positive and negative outcome groups had significantly lower NRS pain scores than at baseline. Multivariable analysis revealed that male gender ( = 0.023) was an independent predictor of positive SCS outcomes; conversely, longer pain duration ( = 0.011) was a negative predictor. No significant adverse events associated with SCS were observed throughout the six-month follow-up duration. : SCS could be an effective treatment for chronic intractable pain, including complex regional pain syndrome (CRPS) and persistent spinal pain syndrome (PSPS). More successful outcomes may be expected in male patients with a shorter duration of pain. Additional research is required to enhance patient selection processes and to identify clinical characteristics that contribute to improved long-term outcomes.

摘要

脊髓刺激(SCS)用于治疗慢性顽固性疼痛,但预测其有效性的因素尚未得到广泛研究。我们的研究旨在确定能够预测SCS治疗结果的临床变量。回顾了2008年至2022年在韩国两所大型三级教学机构接受SCS治疗慢性顽固性疼痛患者的电子病历。成功的治疗结果表现为在6个月时评估的数字评分量表(NRS)上疼痛至少减轻50%。采用多变量分析来研究SCS治疗结果与临床变量之间的相关性。在213例患者中,108例(50.7%)在SCS植入后6个月取得了成功的治疗结果。在6个月时,阳性和阴性治疗结果组的NRS疼痛评分均显著低于基线水平。多变量分析显示,男性(P = 0.023)是SCS阳性治疗结果的独立预测因素;相反,疼痛持续时间较长(P = 0.011)是阴性预测因素。在整个六个月的随访期间,未观察到与SCS相关的显著不良事件。结论:SCS可能是治疗慢性顽固性疼痛(包括复杂性区域疼痛综合征(CRPS)和持续性脊柱疼痛综合征(PSPS))的有效方法。疼痛持续时间较短的男性患者可能会有更成功的治疗结果。需要进一步研究以改进患者选择过程,并确定有助于改善长期治疗结果的临床特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f108/12190966/b29c0c66978d/brainsci-15-00614-g001.jpg

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