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Spinal cord stimulation in deafferentation pain
M J Sánchez-Ledesma1, G García-March, P Diaz-Cascajo
1Department of Neurosurgery, Hospital Universitario, Salamanca, Spain.
Stereotactic and Functional Neurosurgery
|January 1, 1989
Summary
Spinal cord stimulation (SCS) effectively manages resistant deafferentation pain in many patients. Over half experienced significant pain relief after permanent implantation, with minimal side effects.
Area of Science:
- Neurology
- Pain Management
- Neurosurgery
Background:
- Deafferentation pain, a challenging condition, arises from nerve damage.
- Conditions include causalgia, phantom limb pain, and postherpetic neuralgia.
- Spinal cord stimulation (SCS) offers a potential therapeutic option.
Purpose of the Study:
- To evaluate the efficacy of spinal cord stimulation (SCS) for resistant deafferentation pain.
- To assess long-term outcomes and side effects of SCS in a diverse patient cohort.
Main Methods:
- Percutaneous epidural leads were implanted in 49 patients with various deafferentation pain syndromes.
- A two-week trial period assessed stimulation-induced paresthesia in painful areas.
- Successful trial patients (36/49) underwent permanent SCS device implantation.
Main Results:
- 57% of patients achieved satisfactory pain relief (over 75%) after a mean follow-up of 5.5 years.
- Positive response during the trial predicted long-term efficacy.
- Adverse events were infrequent, including electrode dislodgement and wire extrusion.
Conclusions:
- Spinal cord stimulation is a viable treatment for refractory deafferentation pain.
- Long-term pain relief and manageable side effects support SCS as a therapeutic modality.
- Careful patient selection and lead placement are crucial for optimal outcomes.