論文

国際誌
2021年7月2日

Benefit of spinal cord stimulation for patients with central poststroke pain: a retrospective multicenter study.

Journal of neurosurgery
  • Koichi Hosomi
  • Takamitsu Yamamoto
  • Takashi Agari
  • Shinichiro Takeshita
  • Takafumi Tanei
  • Hirochika Imoto
  • Nobuhiko Mori
  • Satoru Oshino
  • Kaoru Kurisu
  • Haruhiko Kishima
  • Youichi Saitoh
  • 全て表示

136
2
開始ページ
1
終了ページ
12
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.3171/2020.11.JNS202999

OBJECTIVE: Spinal cord stimulation (SCS) has been considered an ineffective procedure for patients with central poststroke pain (CPSP). However, recent case series that included small numbers of patients reported the possible efficacy of SCS as a treatment of CPSP. This multicenter retrospective study aimed to examine the outcomes of using SCS to treat patients with CPSP and to explore factors related to outcomes. METHODS: The authors reviewed the medical records of patients with CPSP who underwent SCS to collect data regarding their background, surgical information, and outcomes of SCS at trial stimulation and last follow-up after long-term implantation in six study centers. Outcomes were evaluated with a pain score for intensity (range 0-10) and the Patient Global Impression of Changes (PGIC) scale. Factors associated with outcomes were explored with univariable and multivariable analyses. RESULTS: The authors collected data from a total of 166 patients (mean age 63.4 years; mean pain score at baseline 8.2). Of these patients, 163 underwent trial stimulation. The mean pain score decreased by 42.0%, 104 (64%) patients had ≥ 30% decrease in pain score, and 96 (59%) reported much or very much improved condition on the PGIC scale at trial stimulation. Moreover, 106 (64%) patients underwent long-term implantation of SCS devices. The mean decrease in pain score was 41.4%, 63 (59%) patients continued to show ≥ 30% decrease in pain score at last follow-up, and 60 (56%) reported much or very much improved condition on the PGIC scale at last follow-up (median [range] follow-up period 24 [24-63] months). Eleven device-related complications and 10 permanent explantations were observed. Univariable and multivariable analyses suggested that young age, less sensory disturbance, implantation of cervical leads, treatment of upper-limb pain, and extensive treated regions were associated with satisfactory outcomes at last follow-up after long-term implantation. CONCLUSIONS: These findings indicate that SCS may modestly benefit patients with CPSP. SCS has therapeutic potential for patients with intractable CPSP owing to the lower invasiveness of the SCS procedure and refractory nature of CPSP. Nevertheless, trial stimulation is necessary because of the high initial failure rate.

リンク情報
DOI
https://doi.org/10.3171/2020.11.JNS202999
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/34214987
ID情報
  • DOI : 10.3171/2020.11.JNS202999
  • PubMed ID : 34214987

エクスポート
BibTeX RIS