Spinal Cord Stimulation for Management of Pain in Chronic Pancreatitis: A Systematic Review of Efficacy and Complications.

Objectives: Spinal cord stimulation (SCS) has been used to manage pain in patients with chronic pancreatitis (CP). The aim of this systematic review was to summarize the effectiveness and complications of SCS in the management of pain associated with CP.

Materials And Methods: An exploratory systematic review was performed through a literature search of the PubMed, Medline, EMBASE, SCOPUS, and Cochrane databases.

Results: Seven studies including 31 patients met the inclusion criteria. There was one observational cohort study, two case series, and four case reports. The estimated median age of the study group was 44 years (range 21-87 years) in primarily nonalcoholic CP (74%, 23/31). The SCS leads were typically placed at the level of T6-T8 in the epidural space. All patients reported an improvement in pain. The estimated median reduction of visual analogue pain scores was 61% (range 50%-100%) with an estimated median reduction of morphine equivalent opioid use of 69% (range 25%-100%) at the end of follow-up (less than one to greater than two years). Infection at the site of the lead occurred in 2 of the 31 (6%) and lead migration in 2 of the 31 (6%) patients.

Conclusions: This systematic review suggests that SCS has a potentially efficacious role in reducing pain and opioid use in patients with CP.