gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Evaluation of cervical spinal cord stimulation in the treatment of cervical neuropathic pain syndromes

Meeting Abstract

  • J. Walter - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Jena, Jena, Deutschland
  • M. Teubner - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Jena, Jena, Deutschland
  • S. Frank - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Jena, Jena, Deutschland
  • R. Kalff - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Jena, Jena, Deutschland
  • R. Reichart - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Jena, Jena, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocFR.11.03

DOI: 10.3205/12dgnc257, URN: urn:nbn:de:0183-12dgnc2571

Published: June 4, 2012

© 2012 Walter et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: The aim of this study is to evaluate the effects of a cervical spinal cord stimulation (cSCS) in the treatment of patients with chronic cervical neuropathic pain syndromes including chronic cervicobrachialgia, lesions of the brachial plexus and peripheral nerve lesions as well as rare cases like cSCS in post-zoster-neuropathy, neuropathic pain in tetraplegia and after complex shoulder injuries.

Methods: Thirty consecutively treated patients with permanent cervical SCS between 03/2006 and 03/2011 and a maximum follow-up time up to 6 years are included in the study. Patients provided data on pain using the visual analogue scale (VAS), quality of life, function, pain medication and return to work. Furthermore technical details like the type of electrodes used, electrode placement site, ratio if testing and permanent stimulation, operating time, number of device-related surgical revisions and adverse events were assessed.

Results: 30 out of 38 patients, tested for cSCS, received the permanent stimulation device and were then included in this follow-up study. The mean age of the 14 men and 16 women in the study was 56.3 years. The average VAS pain score for all patients was 8.3 at baseline and 5.3 twelve months after implantation with a further decrease to 4.4 after 24 months. 79.6% of the patients showed a pain reduction after cSCS. Up to now 25 patients continue to experience significant pain relief. 71.4% indicated surgery to be successful. 43.2% of the employable patients could return to work after cSCS. Best results in pain reduction were achieved using 8-polar plate leads. 2 systems had to be explanted due to complete reduction of effectiveness and 3 patients received an additional implanted intrathecal infusion pump. 3 displacements of stab leads needed surgical revisions and were replaced by plate leads. There was no hardware malfunction and only 2 superficial wound infections. The successful patients reported improvements in daily living as well as a decrease in analgesic usage with a significant decrease in opiate consumption.

Conclusions: Until now there is hardly any literature on the outcome of cervical SCS in the treatment of cervical radicular or diffuse cervical neuropathic pain. This study demonstrates the safety and efficacy of cSCS in 30 well-selected patients with an average two-year reduction of pain in nearly 50%, a significant decrease in opiate consumption and only 4 device-related minor surgical revisions.