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Spinal cord stimulation (SCS) in peripheral ischemic pain
Pacing and Clinical Electrophysiology : PACE
|April 1, 1989
Summary
Epidural neurostimulation effectively manages peripheral vascular disease pain and improves walking distance. Transcutaneous oxygen tension (TcpO2) predicts successful outcomes, offering an objective measure for patient selection.
Area of Science:
- Neurology
- Vascular Surgery
- Pain Management
Background:
- Peripheral vascular disease (PVD) causes debilitating pain unresponsive to conventional treatments.
- Epidural neurostimulation (ENS) is an alternative therapy for intractable PVD pain.
Purpose of the Study:
- To evaluate the efficacy of ENS for PVD pain management.
- To determine if transcutaneous oxygen tension (TcpO2) can predict ENS treatment success.
Main Methods:
- 45 PVD patients received epidural neurostimulators.
- Outcomes assessed: pain control, walking distance, trophic lesion healing.
- Transcutaneous oxygen tension (TcpO2) measured pre- and during testing to predict efficacy.
Main Results:
- Satisfactory, long-lasting pain relief achieved in most patients.
- Significant improvement in walking distance observed.
- Trophic lesions <3 sq cm healed; larger lesions necessitated amputation.
- Pain symptom regression correlated with improved TcpO2.
Conclusions:
- Epidural neurostimulation is effective for intractable PVD pain.
- Improved TcpO2 during testing predicts successful ENS outcomes.
- TcpO2 offers an objective criterion for selecting patients for ENS implantation.