Background: Spinal cord stimulation (SCS) can impact sensory, pain and tolerance thresholds in various ways, which can be accessed via quantitative sensory testing (QST). The objectives of this study were to (1) assess the subjective sensory responses using QST in patients following SCS therapy for PSPS and (2) to get a clinical impression of the results of SCS during an interview of these patients with PSPS and SCS during long term follow-up.
Methods: Forty patients with PSPS who received SCS treatment underwent QST via electrical and mechanical pressure stimuli. QST was performed at four different moments (1) pre-implantation SCS, (2) two weeks postoperatively, (3) three months after permanent SCS implantation and (4) six months after permanent SCS implantation. Patients' perspectives on pain, use of drugs and quality of life were assessed via semi-structured interviews during a follow-up between 5 and 11 years.
Results: We found statistical significant differences in the changes of sensory, pain and tolerance thresholds. A decrease in pain complaints and analgesics use were reported by the patients during follow-up. The quality of life in patients increased from three to eight (NRS 0 [worst QoL imaginable] -10 [best QoL imaginable]) after receiving SCS.
Conclusions: The increased thresholds on areas without pain or being covered by the SCS induced paresthesias may indicate that there are central changes contributing to these deviations in thresholds. The overall QoL in patients improved greatly after receiving SCS.
Significance: This study provides an overview of the effect of SCS on sensory, pain and tolerance thresholds in patients with PSPS throughout the SCS treatment process. In addition, this study presents data from 40 patients with PSPS treated with SCS, analysing several long-term patient-reported outcome measures. The results serve to give more insight into the mechanism of SCS and document SCS as a possible treatment for PSPS.
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http://dx.doi.org/10.1002/ejp.1984 | DOI Listing |
Neuromodulation
January 2025
MetroHealth Rehabilitation Institute, Metrohealth System, Cleveland, OH, USA; Department of Physical Medicine and Rehabilitation, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Objectives: Spinal cord stimulation (SCS) is a therapeutic option for those with chronic pain due to persistent spinal pain syndrome (PSPS). Current literature suggests a higher rate of SCS explant in female patients, but evidence regarding sex differences in the rates of receiving SCS therapy is limited. We do not know whether there is a disparity between female and male patients who receive SCS therapy.
View Article and Find Full Text PDFiScience
December 2024
CHU de Poitiers, PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), 86000 Poitiers, France.
Given the multidimensional aspect of pain, the assessment of treatment efficacy is challenging. The prospective observational multicenter PREDIBACK study aimed to assess, compare, and predict the effectiveness of different treatments for persistent spinal pain syndrome type 2 (PSPS-T2) using a digital tool and the Multidimensional Clinical Response Index (MCRI) including pain intensity, functional disability, quality of life, anxiety and depression, and pain surface. Results indicated that neurostimulation was the most effective treatment at 3-, 6-, 9-, and 12-month follow-up compared to baseline, leading to significant improvements in pain, function, and quality of life, whereas optimized medical management (OMM) and spinal reoperation showed no significant benefits.
View Article and Find Full Text PDFHead Neck
December 2024
Department of Otolaryngology - Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA.
Objectives: Virtual surgical planning (VSP) allows for optimal reconstruction of maxillary defects with fibula free flaps. Current data are limited regarding long-term complications of patient-specific plates (PSPs) in this setting. Our objective was to determine long-term complications of PSPs in maxillary reconstruction using fibula free flaps.
View Article and Find Full Text PDFEur J Pain
January 2025
PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, Poitiers, France.
Pain Physician
November 2024
Makous Research, LLC, Carlsbad, CA.
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