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高频脊髓刺激治疗特发性不对称性小纤维神经病变的疗效:病例报告

Efficacy of High-Frequency Spinal Cord Stimulation in Idiopathic Asymmetrical Small-Fiber Neuropathy Case Report.

作者信息

Mohabbati Vahid, Mohabbati Parsa, Papan Mohammadkazem

机构信息

Sydney Pain Research Centre, Sydney, NSW, Australia.

Sydney Pain Management Centre, Sydney, NSW, Australia.

出版信息

Pain Med Case Rep. 2024 Jul;8(5):185-190.

Abstract

BACKGROUND

Small-fiber neuropathies (SFNs), affecting thinly myelinated Ad fibers and unmyelinated C fibers, often manifest with sensory or autonomic symptoms in varied patterns. Diagnostic tools comprise skin biopsy, quantitative sensory, autonomic testing, and biochemical markers. Spinal cord stimulation (SCS), particularly high-frequency SCS, has emerged as a pivotal therapeutic intervention. CASE REPORT: This study delves into a 49-year-old woman diagnosed with idiopathic asymmetrical SF peripheral neuropathy, examining her 12-month postoperative trajectory after SCS implantation. Postsurgical assessment revealed substantial improvements: baseline pain (Numeric Rating Scale 7) decreased to 4 at 3 months, indicating reduced intensity; Oswestry Disability Index improved from 38% to 4%, highlighting enhanced functionality; Patient-Specific Questionnaire 3 average score dropped from 35 to 2, indicating improved outcomes in specific pain-related concerns. CONCLUSIONS: This case report underscores the efficacy of SCS in managing idiopathic asymmetrical SFN, demonstrating significant symptomatic relief over a 12-month postoperative period.

摘要

背景

小纤维神经病变(SFN)会影响薄髓鞘Aδ纤维和无髓鞘C纤维,常以多种模式表现出感觉或自主神经症状。诊断工具包括皮肤活检、定量感觉测试、自主神经测试和生化标志物。脊髓刺激(SCS),尤其是高频SCS,已成为一种关键的治疗干预手段。病例报告:本研究深入探讨了一名49岁被诊断为特发性不对称性SF周围神经病变的女性,检查了她在植入SCS后的12个月术后病程。术后评估显示有显著改善:基线疼痛(数字评分量表为7)在3个月时降至4,表明疼痛强度降低;奥斯维斯特里残疾指数从38%提高到4%,突出了功能的增强;患者特定问卷3的平均得分从35降至2,表明在特定疼痛相关问题上结果有所改善。结论:本病例报告强调了SCS在治疗特发性不对称性SFN方面的疗效,显示出术后12个月内有显著的症状缓解。

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