One-Year Outcomes of Spinal Cord Stimulation of the Dorsal Root Ganglion in the Treatment of Chronic Neuropathic Pain

被引:166
作者
Liem, Liong [1 ]
Russo, Marc [2 ]
Huygen, Frank J. P. M. [3 ]
Van Buyten, Jean-Pierre [4 ]
Smet, Iris [4 ]
Verrills, Paul [5 ]
Cousins, Michael [6 ]
Brooker, Charles [7 ]
Levy, Robert [8 ]
Deer, Timothy [9 ]
Kramer, Jeffrey [10 ]
机构
[1] St Antonius Hosp, Nieuwegein, Netherlands
[2] Hunter Pain Clin, Newcastle, NSW, Australia
[3] Erasmus Univ, Rotterdam, Netherlands
[4] AZ Nikolas, St Niklaas, Belgium
[5] Metro Spinal Clin, Melbourne, Vic, Australia
[6] Univ Sydney, Sydney, NSW 2006, Australia
[7] Royal N Shore Hosp, Sydney, NSW, Australia
[8] Boca Raton Reg Hosp, Marcus Neurosci Inst, Boca Raton, FL USA
[9] Ctr Pain Relief Inc, Charleston, WV USA
[10] Spinal Modulat Inc, Menlo Pk, CA USA
来源
NEUROMODULATION | 2015年 / 18卷 / 01期
关键词
Back pain; complex regional pain syndrome; dorsal root ganglion; failed back surgery syndrome; foot pain; leg pain; neuropathic pain; spinal cord stimulation; visual analog scale; BACK SURGERY SYNDROME; CONVENTIONAL MEDICAL-MANAGEMENT; RANDOMIZED CONTROLLED-TRIAL; INTRACTABLE PAIN; MULTICENTER; COMPLICATIONS; RECOMMENDATIONS; VALIDATION; INVENTORY; SYSTEM;
D O I
10.1111/ner.12228
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
ObjectivesSpinal cord stimulation of the dorsal root ganglion (DRG-SCS) is a new therapy for treating chronic neuropathic pain. Previous work has demonstrated the effectiveness of DRG-SCS for pain associated with failed back surgery syndrome, complex regional pain syndrome, chronic postsurgical pain, and other etiologies through 6 months of treatment; this report describes the maintenance of pain relief, improvement in mood, and quality of life through 12 months. Materials and MethodsSubjects with intractable pain in the back and/or lower limbs were implanted with an active neurostimulator device. Up to four percutaneous leads were placed epidurally near DRGs. Subjects were tracked prospectively for 12 months. ResultsOverall, pain was reduced by 56% at 12 months post-implantation, and 60% of subjects reported greater than 50% improvement in their pain. Pain localized to the back, legs, and feet was reduced by 42%, 62%, and 80%, respectively. Measures of quality of life and mood were also improved over the course of the study, and subjects reported high levels of satisfaction. Importantly, excellent pain-paresthesia overlap was reported, remaining stable through 12 months. DiscussionDespite methodological differences in the literature, DRG-SCS appears to be comparable to traditional SCS in terms of pain relief and associated benefits in mood and quality of life. Its benefits may include the ability to achieve precise pain-paresthesia concordance, including in regions that are typically difficult to target with SCS, and to consistently maintain that coverage over time.
引用
收藏
页码:41 / 49
页数:9
相关论文
共 40 条
[31]  
Sapunar Damir, 2012, J Pain Res, V5, P31, DOI 10.2147/JPR.S26603
[32]  
Schu S., 2014, Pain Pract
[33]   Long-Term Outcomes of Spinal Cord Stimulation With Paddle Leads in the Treatment of Complex Regional Pain Syndrome and Failed Back Surgery Syndrome [J].
Sears, Nathaniel C. ;
Machado, Andre G. ;
Nagel, Sean J. ;
Deogaonkar, Milind ;
Stanton-Hicks, Michael ;
Rezai, Ali R. ;
Henderson, Jaimie M. .
NEUROMODULATION, 2011, 14 (04) :312-318
[34]  
SIMPSON EL, 2009, HEALTH TECHNOL ASSES, V13, P1
[35]  
Smet I., 2014, PAIN PRACT
[36]   Experimental Spinal Cord Stimulation and Neuropathic Pain: Mechanism of Action, Technical Aspects, and Effectiveness [J].
Smits, Helwin ;
van Kleef, Maarten ;
Holsheimer, Jan ;
Joosten, Elbert A. J. .
PAIN PRACTICE, 2013, 13 (02) :154-168
[37]   Validation of the brief pain inventory for chronic nonmalignant pain [J].
Tan, G ;
Jensen, MP ;
Thornby, JI ;
Shanti, BF .
JOURNAL OF PAIN, 2004, 5 (02) :133-137
[38]   The cost effectiveness of spinal cord stimulation in the treatment of pain: A systematic review of the literature [J].
Taylor, RS ;
Taylor, RJ ;
Van Buyten, MP ;
Buchser, E ;
North, R ;
Bayliss, S .
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 2004, 27 (04) :370-378
[39]   Spinal cord stimulation for patients with failed back surgery syndrome or complex regional pain syndrome: a systematic review of effectiveness and complications [J].
Turner, JA ;
Loeser, JD ;
Deyo, RA ;
Sanders, SB .
PAIN, 2004, 108 (1-2) :137-147
[40]  
WILLIAMS A, 1990, HEALTH POLICY, V16, P199