Document Detail


Spinal cord stimulation for central poststroke pain.
MedLine Citation:
PMID:  20679928     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although spinal cord stimulation (SCS) has been shown to be effective for treating neuropathic pain of peripheral origin, its effectiveness for central poststroke pain (CPSP) is not well established.
OBJECTIVE: We report our experience with SCS in 30 consecutive patients with intractable CPSP.
METHODS: All patients underwent a percutaneous SCS trial. When patients decided to proceed, they received a permanent SCS system. Pain intensity was evaluated by a visual analogue scale (VAS). The Patient Global Impression of Change (PGIC) scale was also assessed at the latest follow-up visit as an indicator of overall improvement.
RESULTS: During trial stimulation, pain relief was good (> or =50% VAS score reduction) in 9 patients (30%), fair (30%-49% reduction) in 6 patients (20%), and poor (<30% reduction) in 15 patients (50%). Ten patients elected to receive a permanent SCS system. Nine of these 10 patients were followed long-term (mean, 28 months; range, 6-62 months). Seven patients reported significant pain relief on the VAS (5 = good and 2 = fair). On the PGIC scale, 6 of these 7 patients reported a rating of 2 (much improved) and 1 reported a rating of 3 (minimally improved). Of the remaining 2 patients, 1 reported a rating of 4 (no change) and 1 reported a rating of 5 (minimally worse). The median VAS score in the 9 patients decreased significantly from 8.6 (range, 6.0-10.0) to 4.5 (range, 3.0-8.0; P = .008). There were no significant reported complications.
CONCLUSION: SCS may provide improved pain control in a group of patients with intractable CPSP and may have therapeutic potential for intractable CPSP.
Authors:
Mohamed M Aly; Youichi Saitoh; Koichi Hosomi; Satoru Oshino; Haruhiko Kishima; Toshiki Yoshimine
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  67     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-23     Completed Date:  2010-12-13     Revised Date:  2011-09-12    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  ons206-12; discussion ons212     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Osaka University Graduate School of Medicine, Osaka, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Electric Stimulation Therapy / methods*
Electrodes, Implanted
Female
Follow-Up Studies
Humans
Magnetic Resonance Imaging / methods
Male
Middle Aged
Pain / etiology,  therapy*
Pain Measurement
Retrospective Studies
Spinal Cord / physiology*
Stroke / complications
Treatment Outcome
Comments/Corrections
Comment In:
Neurosurgery. 2011 May;68(5):E1507; author reply E1507-8   [PMID:  21307784 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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