Effects of spinal cord stimulation (SCS) in patients with inoperable severe lower limb ischaemia: A prospective randomised controlled study

Jivegård, Lennart; Augustinsson, Lars-Erik; Holm, Jan; Risberg, Bo; Örtenwall, Per

doi:10.1016/s1078-5884(05)80010-3

Cited by 174 publications

(85 citation statements)

References 17 publications

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“…As judged by a visual analogue scale, pain relief was significantly better in the SCS group after 3 months (P < 0·001) 37 and 12 months (P < 0·01) 23 . In one study 38 , a highly significant reduction in pain score (from a mean of 50 to 25) was found during follow-up, but no difference between the two treatment groups.…”

Section: Pain Reliefmentioning

confidence: 93%

Systematic review and meta-analysis of controlled trials assessing spinal cord stimulation for inoperable critical leg ischaemia

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Vermeulen

Spincemaille

et al. 2004

British Journal of Surgery

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Section: Pain Reliefmentioning

confidence: 93%

Systematic review and meta-analysis of controlled trials assessing spinal cord stimulation for inoperable critical leg ischaemia

Ubbink

Vermeulen

Spincemaille

et al. 2004

British Journal of Surgery

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“…At a mean follow-up of 19 months, there was no significant difference in pain score improvement between the two groups. Conversely, from a similar study in which 51 patients were randomized to receive either oral medication alone or SCS with oral medication, Jivegård et al 72 reported a significant improvement in pain scores of the SCS-treated group, compared with the non-SCS group (p Ͻ 0.01).…”

Section: Chronic Critical Limb Ischemia and Painmentioning

confidence: 96%

Spinal Cord Stimulation: An Update

2008

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Summary:Spinal cord stimulation has been used in the treatment of many chronic pain disorders since 1967. In this update, the indications for spinal cord stimulation are reviewed with attention to recent publications. A focused review of the literature on abdominal and visceral pain syndromes is also provided. Furthermore, the technology has evolved from the use of monopolar electrodes to complex electrode arrays. Similarly, the power source has changed from a radio frequency-driven system to a rechargeable impulse generator. These topics are covered, along with a short discussion of implant technique. Finally, we include a review of complications of such therapy. SCS as a technology and therapy continues to evolve.

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“…Исследования эффективности спинальной нейростимуляции у пациентов с критической ишемией нижних конечностей, проблемы и перспективы применения К настоящему времени в мире выполнено 6 рандо-мизированных клинических [57][58][59][60][61][62] и 1 нерандомизи-рованное исследований [55] по сравнению спинальной нейростимуляции и консервативной терапии в лечении пациентов с критической ишемией нижних конечнос-тей, а также ряд когортных исследований, в которых рассматривалось течение заболевания у пациентов с имплантированной системой SCS (таблица). В боль-шинстве из них выявлено, что спинальная нейрости-муляция улучшает клиническое течение заболевания у пациентов с КИНК, в том числе приводит к меньшему числу ампутаций, в большей степени снижает боле-вой синдром и восстанавливает большее количество пациентов до II стадии по Фонтейну -Покровскому в…”

Section: отбор пациентов для имплантации системы спинальной нейростимunclassified

Spinal cord stimulation in treatment of patients with critical lower limb ischemia

Ashurkov¹,

Levin²,

Murtazin³

et al. 2017

PKiK

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Critical limb ischemia (CLI) is a state of substantial reduction of blood flow in the extremities, mostly due to severe obstruction of the arteries. In lower limbs, it produces severe pain after even a short distance walk (intermittent claudication) and/or skin ulcers or sores. Surgical revascularization is a “golden standard” in CLI therapy, but it is contraindicated or not accessible for a large proportion of patients, while the medical prognosis is poor for conservative therapy. This situation stimulated the development of alternative approaches, including spinal cord stimulation (SCS) and various methods of “indirect” revascularization. In this paper, the authors give a short description of the latest approaches and a detailed review of the SCS method, while paying special attention to the studies that demonstrate not only a palliative effect of SCS (pain reduction), but also clinically significant changes in the indicators of lower limb muscles blood supply. CLI is characterized with a "vicious circle": pain causes reduced mobility and changes in the preferred limb position, which in turn lead to edema triggering an increase of ischemia and further elevation of pain. The clinical effects of SCS in CLI patients are related both with pain relief leading to a break of this vicious circle, and with the direct vasodilatory effects of the stimulation itself. There are several possible biological mechanisms of these actions, but most probably the therapeutic actions of SCS arise from their combination. Examination of different opinions about the appropriateness of spinal cord stimulation in patients with CLI, including those related to the economic efficiency of the method, leads to the conclusion that the evidence on these issues is currently insufficient. The reviewed data demonstrate the need for further development of the CLI treatment methods and high urgency of this problem.Received 6 April 2017. Accepted 23 April 2017.Funding: The study did not have sponsorship. Conflict of interest: The authors declare no conflict of interest.

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Effects of spinal cord stimulation (SCS) in patients with inoperable severe lower limb ischaemia: A prospective randomised controlled study

Cited by 174 publications

References 17 publications

Systematic review and meta-analysis of controlled trials assessing spinal cord stimulation for inoperable critical leg ischaemia

Systematic review and meta-analysis of controlled trials assessing spinal cord stimulation for inoperable critical leg ischaemia

Spinal Cord Stimulation: An Update

Spinal cord stimulation in treatment of patients with critical lower limb ischemia

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