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Kaare Meier

Spinal Cord Stimulation in Severe Cases of Complex Regional Pain Syndrome: A Retrospective Cohort Study with Long-Term Follow-up

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BACKGROUND: Complex regional pain syndrome (CRPS) is a debilitating pain condition often resistant to standard treatment modalities. In these cases, spinal cord stimulation (SCS) can be an option, but the effect on CRPS remains disputed. We aimed to assess the long-term effect of SCS on CRPS.

METHODS: We retrospectively analyzed 51 CRPS patients implanted with an SCS system at the University Hospitals in Aarhus or Odense, Denmark, with a median follow-up time of 4.4 years. Primary outcomes were pain intensity on a numeric rating scale (NRS) and the Patients' Global Impression of Change (PGIC). Secondary outcomes were patient satisfaction, work status, consumption of pain medication, the Major Depression Inventory (MDI), Pain Catastrophizing Scale (PCS), and quality of life (QoL) measured using the Short-Form Health Survey (SF-36). For each outcome measure, baseline data were compared to the latest collected data point.

RESULTS: A significant pain relief was found with a mean reduction in NRS score of 2.4 (95%CI: 1.7-3.0, P<0.0001). 68.8% reported 'much improved' or 'very much improved' on the PGIC scale. 87.5% would choose SCS again for the same outcome. A significant beneficial impact was found on MDI score, PCS, SF-36 summary scores, and consumption of tricyclic antidepressants, antiepileptic drugs, and opioids. No statistical effect was found on work status.

CONCLUSION: Pain intensity, depression, pain catastrophizing, pain medication use, and QoL were significantly improved after SCS implantation, with high patient satisfaction rates in CRPS patients. This study supports the continued use of SCS in the treatment of severe CRPS.
OriginalsprogEngelsk
TidsskriftEuropean Journal of Pain
ISSN1090-3801
DOI
StatusUdgivet - 1 jul. 2021

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