AI Article Synopsis
- The study examines the long-term effects of spinal cord stimulation (SCS) on patients with chronic pain and critical lower limb ischemia (CLLI), focusing on clinical outcomes one year post-treatment.
- Results show that 74% of patients experienced improved clinical status, including pain reduction and enhanced mobility, along with increased microcirculatory blood flow (MBF) and metabolism in the affected foot.
- Negative outcomes were linked to factors such as high comorbidity rates, low transcutaneous oxygen measurements (TcO <10 mmHg), and prolonged duration of pain.
Article Abstract
Aim: To study the clinical dynamics in the long-term period after spinal cord stimulation (SCS) in patients with chronic pain syndrome and critical lower limb ischemia (CLLI) and to identify factors affecting the prognosis of SCS.
Material And Methods: The clinical dynamics was analyzed in 48 patients with pain syndrome and CLLI 1 year after SCS. Microcirculatory blood flow (MBF) was studied in the affected foot by laser-doppler flowmetry (LDF) (Perfusion Units (PU)) and transcutaneous oximetry (TcpO, mmHg.) using an occlusive test before and after SCS. The factors associated with negative clinical dynamics 1 year after SCS were determined.
Results: In 74% of cases, SCS contributes to the improvement of clinical status (reduction of pain syndrome, increase in motor activity, healing of ulcers). After SCS, according to LDF and TcpO, the authors observed an increase in MBF and tissue metabolism - from 1.3 (0.7-2.8) to 6.2 (3.8-8.7) PU and from 14.5 (7.5-22.1) to 41.1 (26.4-57.6) mmHg, respectively with normalization of the MBF reserve during the occlusion test. Negative clinical dynamics after SCS is associated with high comorbidity, TcO <10 mmHg and the duration of pain.
Conclusion: SCS contributes to the improvement of the clinical status of patients with chronic pain syndrome and CLLI. The negative dynamics is associated with high comorbidity, TcrO <10 mmHg and the duration of pain.
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| http://dx.doi.org/10.17116/jnevro201911909123 | DOI Listing |
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