Artikel
Treatment of complex regional pain syndrome type I of the upper limb by spinal cord stimulation: a prospective study
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Autoren
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P. Dam Hieu
- Service de Neurochirurgie, CHU de la Cavale Blanche, Brest
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B. Quinio
- Unité d'Evaluation et de Traitement de la Douleur, CHU de la Cavale Blanche, Brest
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C. Grall
- Unité d'Evaluation et de Traitement de la Douleur, CHU de la Cavale Blanche, Brest
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T. Dailland
- Service de Neurochirurgie, CHU de la Cavale Blanche, Brest
| Veröffentlicht: | 4. Mai 2005 |
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Gliederung
Text
Objective
A monocentric prospective study was conducted to evaluate the efficacy of Spinal Cord Stimulation (SCS) in treating patients having persistent and intractable Complex regional Pain Syndrome (type I) of the upper limb.
Methods
From January 2003 to December 2003, ten patients (7 males, 3 females, mean-age 44) having severe CRPS I involving the upper arm were carefully elected for SCS by a multidisciplinary team. CRPS had been developing for 54 months (24-108 months). Pre and post operative evaluations (1, 6 and 12 months) included assessment of pain (VAS), trophic perturbations, functional disability (Oswestry score) and medication consumption.
Results
All patients except one were significantly improved by SCS. The mean VAS dramatically decreased: preoperatively VAS=7.9, at 6 months VAS=3.7, at 12 months VAS=3.6. The pre operative mean Oswestry Score was 47,5 and 21 at 12 months. Eight patients were able to use their upper limb (especially the hand) again. Trophic modifications due to CRPS improved in seven patients. Medication consumption was significantly reduced. Preoperatively, all patients were receiving medications. One year later, 6 patients have totally interrupted their medical treatment. No adverse effect was observed except in one patient, who suffered from persistent neck pain.
Conclusions
In carefully selected patients, SCS represents a safe and effective treatment of CRPS type I of the upper arm, resulting in pain reduction and functional improvement. This treatment is particularly effective for patients having a long lasting disease.
