Spinal cord stimulation in critical limb ischemia. A review

This paper reviews the actual clinical experience and alleged working mechanisms of spinal cord stimulation (SCS) in the treatment of non-reconstructable critical leg ischaemia. SCS appears to be beneficial particularly for relief of pain and healing of ischaemic ulcers. The evidence available as to limb salvage is still dubious, because most of the studies performed so far are non-randomised, and different causes for peripheral ischaemia are studied simultaneously. Investigation of the local skin microcirculation, in particular by means of transcutaneous oxygen pressure measurements, appears important to select those patients that will benefit most of SCS treatment, to predict limb survival and to further elucidate the working mechanism of SCS.