![]() ![]() Median NRS before implantation of the neurostimulator was 8.8 (IQR 25−75 7.6–9.3). The median MPSS Score was 3 of 3 indicating a high pain chronicity. Patients median age was 43 years (IQR 25−75 37–43 years). Statistical analysis was performed using Mann–Whitney U and Wilcoxon rank-sum test. Patients were retrospectively analyzed before implantation and 6, 12 and 24 months postoperatively. After successful trial a neurostimulator was implanted and connected to the electrode. A SCS electrode was implanted for trial stimulation. ![]() All patients received conventional pharmacological treatments including multimodal pain therapy through their local pain therapist or in specialized centers as well as physical therapy. Pain intensity (NRS), activity level and health-related quality of life (EQ-5D-5L), the actual mood state (ASTS), and treatment satisfaction (CSQ-8) were assessed. Pain chronicity was recorded with the Mainz Pain Staging System (MPSS). MethodsĪ retrospective case analysis of six patients with severe CRPS was performed. In this study the treatment with spinal cord stimulation (SCS) was evaluated over 24 months follow up. Neurosurgical treatment is not widely offered. © 2020 International Neuromodulation Society.Complex regional pain syndrome (CRPS) is a common pain condition which is characterized by pain, functional impairment, and trophic changes. Further prospective studies are required to evaluate this concept.Ĭase series SCS chronic pain complex regional pain syndrome implantation neuropathic pain neurostimulation programming strategies spinal cord stimulation stimulation stimulator. This suggests the potential that combination therapy with t-SCS and DRG-S may be beneficial in patients with CRPS. In our study, concurrent use of t-SCS and DRG-S provided significant improvement in pain and function as compared to using either device alone. The average numeric rating scale pain score decreased from approximately 7 in the regions not covered by t-SCS to 3 after DRG-S implantation, and to 1.25 with concurrent use t-SCS and DRG-S.īoth t-SCS and DRG-S have been shown to be effective in treatment of patients with CRPS. However, in each attempt, all patients consistently reported superior pain relief and improvement in function with the concurrent use of t-SCS and DRG, as compared to DRG alone. After DRG-S implantation, multiple attempts were made in each patient to use DRG-S alone by temporarily turning the t-SCS off. All four patients reported further improvement in their residual pain and function with DRG-S (>60%), and even superior pain relief (>80%) with concurrent use of t-SCS and t-SCS.Īll patients had a diagnosis of lower extremity CRPS-1. These patients also underwent successful trial and implantation of DRG-S. While all these patients had positive results from their t-SCS, they all had areas which lacked coverage, giving them incomplete pain relief. Our study includes four patients with severe CRPS who had all been implanted with a t-SCS. However, there has been no published data, to our knowledge, that looked at the concurrent use of t-SCS and DRG stimulation for treatment of CRPS. There is also evidence that dorsal root ganglion (DRG) stimulation may be superior to t-SCS in CRPS. Complex regional pain syndrome (CRPS) can be effectively treated with spinal cord stimulation (t-SCS).
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