Sindou M, Keravel Y
Neurochirurgie. 1980;26(2):153-7.
A series of 180 patients with painful neurological disorders were treated with TENS. The findings most frequently encountered when the treatment was successful are analyzed. Depending upon the etiology of the primary disorder, good results (i.e. pain relief of 20% or higher) were obtained as follows : -- Peripheral Nerve Involvement : Amputation - 35 cases; Traumatism - 13 cases ; Miscellaneous - 7 cases. (87 %). -- Radicular Syndromes : Epidural scar and/or Arachnoiditis - 19 cases; Miscellaneous - 9 cases. (60 %). -- Post Herpetic Pain : 34 cases. (67 %). -- Brachial Plexus Lesions (Avulsions) : 12 cases. (25 %). -- Spinal Cord Disorders : 17 cases. (11 %). --Thalamic Pain : 5 cases. (0 %). -- Post-Radiation Pain or Carcinomatous Pain : 16 cases. (30 %). Satisfactory long-term results (over 3 years) were maintained in 80 % of cases of peripheral nerve involvement. In all other cases the percentage of pain relief decreased with follow-up. In this series the likelyhood of good results was associated with the following objective data : 1) Pain is generally secondary to deafferentation. 2) Pain is localized. 3) TENS application in close contact with the nervous structure innervating the painful area is more productive. 4) A relative preservation of lemniscal fibers to superior centers must be present so that stimulation can be transmitted.
对180例患有疼痛性神经功能障碍的患者进行了经皮电刺激神经疗法(TENS)治疗。分析了治疗成功时最常出现的结果。根据原发性疾病的病因,获得良好效果(即疼痛缓解20%或更高)的情况如下:——周围神经受累:截肢——35例;创伤——13例;其他——7例。(87%)。——神经根综合征:硬膜外瘢痕和/或蛛网膜炎——19例;其他——9例。(60%)。——带状疱疹后神经痛:34例。(67%)。——臂丛神经损伤(撕脱伤):12例。(25%)。——脊髓疾病:17例。(11%)。——丘脑痛:5例。(0%)。——放疗后疼痛或癌痛:16例。(30%)。80%的周围神经受累病例维持了令人满意的长期效果(超过3年)。在所有其他病例中,疼痛缓解的百分比随随访时间而下降。在本系列中,良好效果的可能性与以下客观数据相关:1)疼痛通常继发于传入神经阻滞。2)疼痛部位局限。3)将TENS应用于与支配疼痛区域的神经结构紧密接触时效果更佳。4)必须存在相对保留至高级中枢的薄束纤维,以便能够传递刺激。