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Spinal cord stimulation in complex regional pain syndrome type 2
Mikkel Kunwald1, Helga Angela Gulisan1, Carsten Reidies Bjarkam1
1Department of Neurosurgery, Aalborg University Hospital, Denmark.
Danish Medical Journal
|July 5, 2022
Summary
Spinal cord stimulation (SCS) offers pain reduction for complex regional pain syndrome type 2 (CRPS-2), but only half of patients benefit significantly. Further research is needed for better patient selection and understanding SCS mechanisms.
Area of Science:
- Neurology
- Pain Management
- Neurosurgery
Background:
- Spinal cord stimulation (SCS) is a treatment option for complex regional pain syndrome (CRPS) refractory to other therapies.
- This study focuses on CRPS type 2 (CRPS-2), characterized by known nerve injury.
Purpose of the Study:
- To evaluate the efficacy of SCS in reducing pain and opioid consumption in patients with CRPS-2.
- To assess the long-term outcomes of SCS for CRPS-2.
Main Methods:
- Retrospective analysis of 16 patients with CRPS-2 treated with SCS at Aalborg University Hospital.
- Data collected from the Neurizon Neuromodulation Database, including six- and 12+-month follow-ups.
- Paired t-tests were used to analyze pain reduction and opioid use.
Main Results:
- 50% of patients (8 out of 16) achieved clinically significant pain reduction.
- Average pain scores decreased from 8.0 to 6.2 (6 months) and 6.0 (12+ months) (p < 0.001).
- No significant change in opioid use was observed; however, 7 patients required revision procedures and 1 system explantation.
Conclusions:
- SCS can provide clinically relevant pain reduction for CRPS-2 patients.
- The effectiveness is limited, with only half experiencing significant benefit.
- High complication rates and costs necessitate further research into patient selection and treatment mechanisms.
