Barolat G, Singh-Sahni K, Staas W E, Shatin D, Ketcik B, Allen K
Division of Functional Neurosurgery, Thomas Jefferson University, Philadelphia, Pa., USA.
Stereotact Funct Neurosurg. 1995;64(3):153-64. doi: 10.1159/000098744.
Forty-eight spinal cord injury victims were implanted with an epidural spinal cord stimulation system to treat spasms that had not satisfactorily responded to medical therapy. All the patients were at least 6 months after the injury. The protocol included assessment by independent examiners preoperatively and at 3, 6, 12 and 24 months after the implant. Pre- and postoperative data collection included the frequency and severity of the spasms. Combining the frequency and intensity scores into a 'severity' score provided a more accurate clinical picture. No patient observed neurological deterioration following the surgical procedure or the neurostimulation treatment. A statistically significant reduction in the severity of the spasms was observed in the follow-up evaluations, with results that progressively increased in time. It is appears that spinal cord stimulation is an effective and safe alternative in the management of spasms in spinal cord injury victims. Its exact role in relation to intrathecal baclofen infusion and ablative procedures remains to be defined.
48名脊髓损伤患者植入了硬膜外脊髓刺激系统，以治疗对药物治疗反应不佳的痉挛。所有患者受伤时间均至少为6个月。该方案包括术前以及植入后3个月、6个月、12个月和24个月由独立检查人员进行评估。术前和术后的数据收集包括痉挛的频率和严重程度。将频率和强度评分合并为“严重程度”评分能提供更准确的临床情况。没有患者在手术过程或神经刺激治疗后出现神经功能恶化。在随访评估中观察到痉挛严重程度有统计学意义的降低，且结果随时间逐渐改善。看来脊髓刺激是脊髓损伤患者痉挛管理中一种有效且安全的替代方法。其与鞘内注射巴氯芬和消融手术相比的确切作用仍有待确定。
