Spinal cord stimulation in complex regional pain syndrome type 2.

Introduction: Spinal cord stimulation (SCS) may be used to treat complex regional pain syndrome (CRPS) when other treatments fail. This study aimed to describe the effects of SCS for CRPS with known nerve injury, i.e. CRPS type 2 (CRPS-2), on pain reduction and opioid use.

Methods: Data from the outpatient clinic were retrieved from the Neurizon Neuromodulation Database. The patient records of 16 patients treated with SCS at Aalborg University Hospital, Denmark, who met the Budapest (2003) criteria for CRPS-2 and completed six- and 12+-month follow-up were included. In Excel, paired t-tests comparison was used to identify the effect of SCS in regard to the aspects mentioned above.

Results: Eight of the 16 patients (50%) enrolled in this study had clinically significant pain reduction when treated with SCS. The average pain reduction for the whole cohort was more than 20%, going from average numerical rating scale 8.0 to 6.2 (p = 0.0006) and 6.0 (p = 0.0011) at the six-month and 12+-month follow-up, respectively. The use of opiods did not change significantly. Seven patients needed revision procedures and the system was explanted in one patient.

Conclusion: SCS may offer clinically relevant pain reduction in CRPS-2. However, in our cohort only half of the patients experienced a clinically significant response, and the costs and complications associated with SCS were considerable. Thus, further knowledge on patient selection and the SCS treatment mechanisms are warranted.

Funding: none.

Trial Registration: not relevant.