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

TY - JOUR

T1 - Spinal Cord Stimulation in Severe Cases of Complex Regional Pain Syndrome: A Retrospective Cohort Study with Long-Term Follow-up

AU - Eriksen, Linda

AU - Terkelsen, Astrid Juhl

AU - Blichfeldt-Eckhardt, Morten Rune

AU - Sørensen, Jens Christian Hedemann

AU - Meier, Kaare

PY - 2021/11

Y1 - 2021/11

N2 - 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.

AB - 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.

KW - Cohort Studies

KW - Complex Regional Pain Syndromes/therapy

KW - Follow-Up Studies

KW - Humans

KW - Pain Measurement

KW - Quality of Life

KW - Retrospective Studies

KW - Spinal Cord

KW - Spinal Cord Stimulation

KW - Treatment Outcome

U2 - 10.1002/ejp.1834

DO - 10.1002/ejp.1834

M3 - Journal article

C2 - 34196075

SN - 1090-3801

VL - 25

SP - 2212

EP - 2225

JO - European Journal of Pain

JF - European Journal of Pain

IS - 10

ER -