Tallis R C, Illis L S, Sedgwick E M, Hardwidge C, Garfield J S
J Neurol Neurosurg Psychiatry. 1983 Jun;46(6):478-84. doi: 10.1136/jnnp.46.6.478.
The results of ten patients with severe, intractable symptoms of arterial disease receiving spinal cord stimulation are reported. Six out of ten patients showed clinical improvement. Three of five patients with severe rest pain obtained complete or very marked relief and one of two patients with moderate rest pain in the legs obtained complete relief. The mean claudication distance in the ten patients increased from 65 to 212 metres during epidural stimulation of the spinal cord. Exercise tolerance as measured on a bicycle ergometer increased by 61%. These changes were associated with small increases in cutaneous and muscle blood flow. In those patients who responded clinically, the improvements seen were maintained as long as spinal cord stimulation was continued. There was no clinical response to transcutaneous (placebo) stimulation and four patients did not respond in any way to spinal cord stimulation. The improvements seen are unlikely to be due to either the natural history of the disease or to a placebo effect. The effect is probably due to antidromic stimulation of the central processes of the first order sensory neurons. It is suggested on the basis of animal studies that this effect may be mediated by release of prostaglandins as well as indirectly via pain relief.
报告了10例患有严重顽固性动脉疾病症状的患者接受脊髓刺激的结果。10例患者中有6例显示出临床改善。5例严重静息痛患者中有3例获得完全或非常显著的缓解，2例腿部中度静息痛患者中有1例获得完全缓解。在脊髓硬膜外刺激期间，这10例患者的平均跛行距离从65米增加到212米。通过自行车测力计测量的运动耐量增加了61%。这些变化与皮肤和肌肉血流的小幅增加有关。在临床上有反应的患者中，只要继续进行脊髓刺激，所观察到的改善就会持续。经皮（安慰剂）刺激没有临床反应，4例患者对脊髓刺激没有任何反应。所观察到的改善不太可能是由于疾病的自然病程或安慰剂效应。这种效应可能是由于对一级感觉神经元的中枢突进行逆向刺激。根据动物研究表明，这种效应可能是由前列腺素的释放介导的，也可能是通过缓解疼痛间接介导的。
