Spinal cord stimulation in severe, inoperable peripheral vascular disease

Objective. To assess the effect of spinal cord stimulation in patients with severe, inoperable peripheral vascular disease, and uncontrolled pain. Patients and methods. A case study of 20 patients with end-stage peripheral vascular disease, either Fontaine Class 3 or 4 limb ischemia. All 20 patients implanted with spinal cord stimulation devices with follow-up from one to five years (mean, 32 months) performed in a multidisciplinary pain treatment center. Results. In the 20 patients implanted with a spinal cord stimulator for peripheral vascular disease, overall there was 75% limb salvage; with Fontaine Class 3 patients there was 86% and with Fontaine Class 4 patients, 69% limb salvage of the treated limbs. Conclusions. Twenty patients with end-stage peripheral vascular disease were implanted with spinal cord stimulators and followed for five years, until amputation or end of life, showing excellent results for limb salvage and minimal complications. The current literature regarding the use of spinal cord stimulation for peripheral vascular disease is reviewed, supporting its benefit for limb salvage and pain relief.