[Spinal cord stimulation for non-reconstructable chronic ritical limb ischemiae: a case report]

Area of Science:

• Cardiovascular Medicine
• Neurology
• Pain Management

Background:

• Peripheral arterial disease (PAD) is a manifestation of systemic atherosclerosis, leading to critical limb ischemia (CLI) with severe pain and ulcers.
• Surgical revascularization is standard for CLI, but comorbidities often contraindicate it, necessitating alternative treatments.
• Spinal cord stimulation (SCS) is a minimally invasive option for pain relief and limb salvage in CLI patients.

Observation:

• A case of chronic CLI with foot gangrene, diagnosed with Burger disease and multiple comorbidities, was treated with SCS.
• Computed tomography angiography revealed extensive arterial occlusions precluding traditional revascularization.
• A temporary SCS device was implanted, followed by a permanent one after positive initial results.

Findings:

• The patient experienced significant pain relief and a 20% improvement in transcutaneous oxygen pressure after SCS.
• Long-term follow-up showed pain stabilization with minimal medication, indicating SCS effectiveness.
• This case represents the first application of SCS for CLI in China.

Implications:

• SCS is a viable and effective treatment for pain control and limb salvage in patients with non-reconstructable CLI.
• SCS improves quality of life for CLI patients who are not candidates for surgical revascularization.
• Further research is needed to evaluate the long-term limb salvage outcomes of SCS in CLI.