耐火性上肢痛の管理における脊髄刺激の臨床的効果
Yanisa Ingkapassakorn1, Songrit Vuttipongkul1, Bunpot Sitthinamsuwan2,3
1Division of Neurosurgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wang Lang Road, Bangkok Noi, Bangkok, 10700, Thailand.
Neurosurgical review
|February 20, 2026
まとめ
脊髄刺激 (SCS) は,重度の上肢痛みを効果的に治療します. この治療は,痛みの種類に関係なく,ほとんどの患者で痛みのスコアを著しく低下させました.
科学分野:
- 神経学 神経学とは
- 疼痛管理 疼痛管理
- 神経外科は神経外科です.
背景:
- 脊髄刺激 (SCS) は,下肢の痛みと比較して,上肢の痛みに対して十分に活用されていない.
- 耐火性上肢痛におけるSCSの有効性に関する証拠は限られている.
研究 の 目的:
- 重症で耐火性の高い上肢の痛みに対するSCSの有効性を評価する.
- 神経病変と非神経病変,複雑な地域疼痛症候群 (CRPS) を含む,異なる疼痛エチオロジーにおけるSCSアウトカムを比較する.
主な方法:
- SCS試験を受ける耐火性上肢痛の13人の患者の見通し評価.
- 11人の患者が,試験に成功した後,永久的なSCSインプラントに移行しました.
- 術前および術後の数値疼痛評価スケール (NPRS) のスコアを収集した.
- 病変のタイプ (神経/非神経) と診断 (CRPS/非CRPS) に基づいたサブグループ分析.
主要な成果:
- 平均NPRSスコアは,移植後の9.5から3.6に大幅に低下した (p<0.001).
- すべての評価されたサブグループで痛みの減少が顕著であった (p <0.05).
- 神経性/非神経性損傷またはCRPS/非CRPS群の間では,痛みの軽減の大きさの有意な違いは見つかりませんでした.
結論:
- SCSは,様々な原因による耐火性上肢の痛みに対する効果的な治療法です.
- SCSの有効性は,CRPSを含む特定の痛みエチオロジーに依存しません.
- SCSは,重度の上肢痛の患者にとって幅広い潜在的な利点を示しています.
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