gms | German Medical Science

Objective: To assess the effects of cervical spinal cord stimulation (cSCS) in patients with chronic neuropathic pain including chronic cervicobrachialgia (17), lesions of the brachial plexus (3) and ulnar nerve (2) as well as rare cases like cSCS in zoster-neuropathy (1), neuropathic pain in tetraplegia (1) and after complex shoulder injury (1).

Methods: Clinical study of cervical SCS with a consecutive inclusion of 25 patients and a mean follow-up time of 22 months. Patients provided data on pain using the visual analogue scale (VAS), quality of life, function and pain medication. Furthermore technical details like type of used electrodes, electrode placement site, number of device-related surgical revisions and adverse events were assessed.

Results: 30 patients were tested for cSCS and 25 received permanent devices. The mean age of the 11 men and 14 women in the study was 54.1 years. Average VAS pain score for all patients was 8.4 at baseline 4.6 at 22 months after implantation. Up to now 23 patients continue to experience significant pain relief. 2 systems had to be explanted due to complete reduction of effectiveness and 1 patient received an additional implanted intrathecal infusion pump. 4 displacements of stab electrodes needed surgical revisions and were replaced by plate electrodes. There was no hardware malfunction and only 1 superficial wound infection. The successful patients reported improvements in daily living as well as a decrease in analgesic usage with a significant decrease in opiate consumption.

Conclusions: Up until now there is nearly no literature on the outcome of cervical SCS in the treatment of cervical radicular or diffuse neuropathic pain. This study demonstrated the safety and efficacy of cSCS in 25 well-selected patients with an average reduction of pain from VAS 8.4 to 4.6 and only 4 device-related minor surgical revisions.