gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Neurophysiological investigation of patients treated with Spinal Cord Stimulation (SCS) for chronic pain

Meeting Abstract

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  • Rezvan Ahmadi - Neurochirurgische Universitätsklinik Heidelberg, Heidelberg, Deutschland
  • Andreas Unterberg - Universitätsklinikum Heidelberg, Klinik für Neurochirurgie, Neurochirurgie, Heidelberg, Deutschland
  • Rolf Treede - Universität Heidelberg, Medizinische Fakultät Mannheim, Abteilung für Neurophysiologie, Abteilung für Neurophysiologie, Mannheim, Deutschland
  • Sigrid Schuh-Hofer - CBTM, Universitätsmedizin Mannheim, Institut für Neurophysiologie, Centrum für Biomedizin und Medizintechnik Mannheim, Mannheim, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocP 152

doi: 10.3205/17dgnc715, urn:nbn:de:0183-17dgnc7152

Published: June 9, 2017

© 2017 Ahmadi et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Spinal Cord Stimulation is an evidence based neuromodulatory procedure for the treatment of chronic pain disorders. However, its mechanism of action has not been explored yet sufficiently. Stimulation paradigms like burst and high frequency modes and their clinical results indicate that SCS acts through different, highly complex pathophysiological pathways. Apart from pilot studies, little is known about the effect of SCS on nociceptive thresholds.

Methods: We present results from a currently ongoing study aiming to systematically assess the impact of SCS on somatosensory perception. We used quantitative sensory testing (QST), a highly standardized methods to quantitatively measure nociceptive parameters. So far, n=6 patients were enrolled in our study. All of them were treated for chronic pain and were examined twice, during her “off” phase and one hour after switching on the stimulator.

Results: According to current interim-analysis, spontaneous pain due to SCS was reduced by 60% at the Visual Analogue Scale (VAS). In all patients showing paradoxical heat sensations (PHS) during the "off phase" (n=2), PHS were ablolished during the "On Phase". Four of our patients exhibited dynamic mechanical allodynia (DMA), which was abolished in three of them during the "On Phase". Due to the currently limited number of patients, we did not find any significant changes regarding Mechanical pain threshold (MPT), Pressure pain threshold (PPT), Mechanical pain sensitivity (MPS), Wind-up ratio (WUR), Mechanical detection threshold (MDT) and Vibration detection threshold (VDT).

Conclusion: QST is a reliable tool to quantitatively assess SCS effects on evoked pain. We suggest including sensory mapping and a comprehensive quantitative sensory testing battery as standard measures for SCS patients to ameliorate selection procedures and to assess long-term effects of SCS.