&lt;p&gt;Current Perspectives on Spinal Cord Stimulation for the Treatment of Cancer Pain&lt;/p&gt;

Hagedorn, Jonathan M; Pittelkow, Thomas P.; Hunt, Christine; D’Souza, Ryan S; Lamer, Tim J.

doi:10.2147/jpr.s263857

Cited by 31 publications

(26 citation statements)

References 69 publications

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“…Spinal cord stimulation (SCS) and dorsal root ganglion stimulation (DRG-S) are minimally invasive surgical approaches that are commonly used for certain refractory pain conditions [ 1 – 4 ]. The expanding indications, progressive improvement in hardware, and development of new programming options have resulted in an increasing number of neuromodulation operations [ 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Skin Closure Technique and Postprocedural Pain after Spinal Cord Stimulator Implantation: A Retrospective Review

D’Souza

North

Pittelkow

et al. 2021

Pain Research and Management

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Spinal cord and dorsal root ganglion stimulation are minimally invasive surgical techniques used to treat an array of chronic pain disorders. There is a paucity of data related to defining best practices in these specific patient populations, and historically, providers have relied on consensus committees to opine on the best techniques for patient safety and experience. The most efficacious mechanism of surgical closure—specifically a running suture closure compared to a surgical staple closure—is debated. A retrospective review of 155 patients implanted with either a spinal cord or dorsal root ganglion stimulator between 2017 and 2019 was undertaken to determine if the type of surgical closure was related to degree of postoperative surgical site discomfort. The primary outcome showed no statistically significant difference on postoperative pain scores between the suture (6.0 (IQR 5.0–8.0)) and staple (7.0 (IQR 5.0–8.0)) cohorts at postoperative day (POD) #1 (adjusted β 0.17 (95% CI −0.61 to 0.95), P = 0.670 ). This finding held for postoperative pain scores at POD #10 as well (staples (1.0 (IQR 0.0–4.0)) and suture (2.0 (IQR 0.0–5.0), adjusted β −0.39 (95% CI −1.35 to 0.58), P = 0.432 )). A regression analysis was performed to identify secondary factors impacting postoperative pain scores. Higher preoperative pain score (β 0.50 (95% CI 0.09 to 0.92), P = 0.019 ) and female gender (β 1.09 (95% CI 0.15 to 2.02), P = 0.023 ) were predictive of higher incisional pain scores at POD#10. Increasing age was associated with decreased incisional pain scores at POD#10 (β −0.06 (95% CI −0.09 to −0.03), P < 0.001 ). These findings are of interest to the pain practitioner and may be valuable in preoperative discussions with prospective patients.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Skin Closure Technique and Postprocedural Pain after Spinal Cord Stimulator Implantation: A Retrospective Review

D’Souza

North

Pittelkow

et al. 2021

Pain Research and Management

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“…A recent publication by Hagedorn et al reviewed the use of SCS for cancer-related pain, both cancer- and treatment-related pain. 17 In general, the literature regarding SCS for the treatment of cancer-related pain is largely represented by case reports and small case series. In 2010, Yakovlev et al reported on 14 patients with lung cancer who underwent SCS for post-surgical pain.…”

Section: Data Evaluation and Discussionmentioning

confidence: 99%

“…Neurolytic blocks, intrathecal drug delivery systems (IDDS), vertebral augmentation, neuromodulation (including spinal cord stimulation (SCS) and dorsal root ganglion stimulation (DRG-S) for neuropathic pain, and radiotherapy have been described. [13][14][15][16][17] Gulati et al 18 and Pak et al 16 have described various interventional techniques including sympathetic blocks, neuromodulation, and intrathecal drug delivery systems for various types of cancer. In a 2019 expert consensus on the management of breakthrough cancer pain in older patients, it was noted that despite discussion between various specialties and available literature, there was no agreement on how interventional techniques should be integrated into the therapeutic strategy.…”

Section: Introductionmentioning

confidence: 99%

The American Society of Pain and Neuroscience (ASPN) Best Practices and Guidelines for the Interventional Management of Cancer-Associated Pain

Aman¹,

Mahmoud²,

Deer³

et al. 2021

JPR

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Moderate to severe pain occurs in many cancer patients during their clinical course and may stem from the primary pathology, metastasis, or as treatment side effects. Uncontrolled pain using conservative medical therapy can often lead to patient distress, loss of productivity, shorter life expectancy, longer hospital stays, and increase in healthcare utilization. Various publications shed light on strategies for conservative medical management for cancer pain and a few international publications have reviewed limited interventional data. Our multi-institutional working group was assembled to review and highlight the body of evidence that exists for opioid utilization for cancer pain, adjunct medication such as ketamine and methadone and interventional therapies. We discuss neurolysis via injections, neuromodulation including targeted drug delivery and spinal cord stimulation, vertebral tumor ablation and augmentation, radiotherapy and surgical techniques. In the United States, there is a significant variance in the interventional treatment of cancer pain based on fellowship training. As a first of its kind, this best practices and interventional guideline will offer evidenced-based recommendations for reducing pain and suffering associated with malignancy.

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“…In multiple reports and retrospective reviews, SCS has been demonstrated to effectively treat cancer-related pain ( 22 – 27 ). Preliminary evidence from small case studies note significant improvements in pain relief from neuromodulation in patients with metastatic bone disease ( 28 , 29 ). It has been also employed to treat chemotherapy-induced neuropathy (CIN) ( 22 , 23 ).…”

Section: Introductionmentioning

confidence: 99%

Spinal Cord Stimulation as Treatment for Cancer and Chemotherapy-Induced Pain

et al. 2021

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Neuropathic pain is a rampant disease exacting a significant toll on patients, providers, and health care systems around the globe. Neuromodulation has been successfully employed to treat many indications including failed back surgery syndrome (FBSS), complex regional pain syndrome (CRPS), phantom limb pain (PLP), radiculopathies, and intractable pelvic pain, among many others. Recent studies have also demonstrated efficacy for cancer-related pain and chemotherapy induced neuropathy with these techniques. Spinal cord stimulation (SCS) is the most commonly employed technique and involves implantation of percutaneous or paddle leads targeting the dorsal columns of the spinal cord with the goal of disrupting the pain signals traveling to the brain. Tonic, high frequency, and burst waveforms have all been shown to reduce pain and disability in chronic pain patients. Closed-loop SCS systems that automatically adjust stimulation parameters based on feedback (such as evoked compound action potentials) are becoming increasingly used to help ease the burden placed on patients to adjust their programming to their pain and position. Additionally, dorsal root ganglion stimulation (DRGS) is a newer technique that allows for dermatomal coverage especially in patients with pain in up to two dermatomes. Regardless of the technique chosen, neuromodulation has been shown to be cost-effective and efficacious and should be given full consideration in patients with chronic pain conditions.

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<p>Current Perspectives on Spinal Cord Stimulation for the Treatment of Cancer Pain</p>

Cited by 31 publications

References 69 publications

Skin Closure Technique and Postprocedural Pain after Spinal Cord Stimulator Implantation: A Retrospective Review

Skin Closure Technique and Postprocedural Pain after Spinal Cord Stimulator Implantation: A Retrospective Review

The American Society of Pain and Neuroscience (ASPN) Best Practices and Guidelines for the Interventional Management of Cancer-Associated Pain

Spinal Cord Stimulation as Treatment for Cancer and Chemotherapy-Induced Pain

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