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Spinal cord stimulation for patients with inoperable chronic critical leg ischemia
Xiao-Pei Chen1, Wei-Min Fu1, Wei Gu1
1Department of Endocrinology and Metabolism, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China (Chen XP, Gu W) Department of Neurosurgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China (Fu WM).
Insights
Spinal cord stimulation (SCS) offers a promising, safe treatment for inoperable chronic critical leg ischemia (CLI), effectively reducing pain compared to traditional methods.
Area of Science:
- Vascular Surgery
- Neurology
- Pain Management
Background:
- Diabetic foot treatment remains challenging.
- Vascular surgery is not a long-term solution for diabetic foot.
- Spinal cord stimulation (SCS) shows promise for inoperable chronic critical leg ischemia (CLI).
Purpose of the Study:
- To evaluate the effectiveness and safety of spinal cord stimulation (SCS) for treating inoperable chronic critical leg ischemia (CLI).
- To review current literature on SCS in managing ischemic pain and limb salvage.
Main Methods:
- A literature search was conducted on the Pubmed database.
- Keywords included "spinal cord stimulation", "ischemic pain", and "limb ischemia" within the last five years.
Main Results:
- SCS is effective in pain reduction for CLI patients.
- Limb salvage and other improvements are not yet definitively agreed upon.
- Common complications include lead migration, connection failure, and infection, but are not fatal.
Conclusions:
- Spinal cord stimulation (SCS) is a safe and promising treatment option for patients with inoperable CLI.
- SCS demonstrates superior pain reduction compared to traditional medical treatments.
Background:
Because of the prevalence of diabetes, the treatment of diabetic foot is still challenging. Even an exactly proved effective and practical method can't be listed except vascular surgery which is not a long-term way for it. Spinal cord stimulation (SCS) is a very promising option in the treatment algorithm of inoperable chronic critical leg ischemia (CLI).
Data Sources:
We searched Pubmed database with key words or terms such as "spinal cord stimulation", "ischemic pain" and "limb ischemia" appeared in the last five years.
Results:
The mechanism of SCS is unclear. Two theories have emerged to interpret the benefits of SCS. Pain relief from SCS can be confirmed by a majority of the studies, while limb salvage and other more ambitious improvements have not come to an agreement. The complications of SCS are not fatal, but most of them are lead migration, lead connection failure, and local infection.
Conclusions:
SCS is a safe, promising treatment for patients with inoperable CLI. It is effective in pain reduction compared with traditional medical treatment.
