Kaare Meier

Spinal cord stimulation in patients with painful diabetic neuropathy: a multicentre randomised clinical trial

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  • Cecile C de Vos, Department of Neurosurgery, Medisch Spectrum Twente, Enschede, the Netherlands; Department of Clinical Neurophysiology, University of Twente, The Netherlands; Stichting neurobionics foundation, Enschede, the Netherlands. Electronic address: c.devos@mst.nl.
  • ,
  • Kaare Meier
  • Paul Brocades Zaalberg, Department of Anesthesiology, St Jansdal Ziekenhuis, Harderwijk, the Netherlands., Ukendt
  • Harold J A Nijhuis, Department of Anesthesiology, St Antonius Ziekenhuis, Nieuwegein, the Netherlands., Ukendt
  • Wim Duyvendak, Department of Anesthesiology, Virga Jessa Hospital, Hasselt, Belgium., Ukendt
  • Jan Vesper, Department of Functional Neurosurgery and Stereotaxy, Heinrich-Heine University, Düsseldorf, Germany., Ukendt
  • Thomas P Enggaard, Department of Anesthesiology, Odense University Hospital, Odense, Denmark.
  • ,
  • Mathieu W P M Lenders, Department of Neurosurgery, Medisch Spectrum Twente, Enschede, the Netherlands; Stichting neurobionics foundation, Enschede, the Netherlands., Ukendt

Painful diabetic neuropathy (PDN) is a peripheral neuropathic pain condition that is often very difficult to relieve. Spinal Cord Stimulation (SCS) is a proven effective therapy for various types of mixed neuropathic conditions, yet effectiveness of SCS treatment for PDN is not well established. This is the first multicentre randomised controlled trial investigating the effectiveness of SCS in patients with PDN. Sixty patients with PDN in the lower extremities, refractory to conventional medical therapy, were enrolled and followed for six months. They were randomised 2:1 to best conventional medical practice with (SCS group) or without (control group) additional SCS therapy and both groups were followed up at regular intervals. At each follow-up visit, the EuroQoL 5D, the short form McGill Pain Questionnaire (SF-MPQ) and a visual analogue scale (VAS, ranging from 0-100) to measure pain intensity were recorded. The average VAS score for pain intensity was 73 in the SCS group and 67 in the control group at baseline. After six months of treatment the average VAS score was significantly reduced to 31 in the SCS group (p<0.001) and remained 67 (p=0.97) in the control group. The SF-MPQ and EuroQoL 5D questionnaires also showed that patients in the SCS group, unlike those in the control group, experienced reduced pain and improved health and quality of life after six months of treatment. In patients with refractory painful diabetic neuropathy, spinal cord stimulation therapy significantly reduces pain and improves quality of life.

OriginalsprogEngelsk
TidsskriftPain
Vol/bind155
Nummer11
Sider (fra-til)2426-2431
ISSN0304-3959
DOI
StatusUdgivet - 2014

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