Spinal cord stimulation in patients with chronic reflex sympathetic dystrophy

Area of Science:

• Neurology
• Pain Management
• Neurosurgery

Background:

• Chronic reflex sympathetic dystrophy (also known as complex regional pain syndrome) is a debilitating condition with no definitive treatment.
• Observational studies suggest spinal cord stimulation (SCS) may alleviate pain associated with this disorder.

Purpose of the Study:

• To evaluate the efficacy of spinal cord stimulation plus physical therapy in managing chronic reflex sympathetic dystrophy.
• To compare SCS with physical therapy alone in a randomized trial.

Main Methods:

• A randomized trial included 54 patients with at least six months of reflex sympathetic dystrophy.
• Patients were assigned to spinal cord stimulation (SCS) plus physical therapy (36 patients) or physical therapy alone (18 patients).
• Pain intensity, perceived effect, functional status, and quality of life were assessed.

Main Results:

• SCS plus physical therapy led to a significant reduction in pain intensity (2.4 cm) compared to physical therapy alone (0.2 cm increase) (P<0.001).
• A higher proportion of patients in the SCS group reported significant improvement (39% vs. 6%, P=0.01).
• Health-related quality of life improved in patients who received SCS, but functional status did not significantly change.

Conclusions:

• Spinal cord stimulation is an effective treatment for reducing pain in carefully selected patients with chronic reflex sympathetic dystrophy.
• SCS can improve health-related quality of life for individuals suffering from this chronic pain condition.