Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Analysis of Failed Spinal Cord Stimulation Trials in the Treatment of Intractable Chronic Pain

  • Jang, Hyun-Dong (Department of Neurosurgery College of Medicine, Yeungnam University) ;
  • Kim, Min-Su (Department of Neurosurgery College of Medicine, Yeungnam University) ;
  • Chang, Chul-Hoon (Department of Neurosurgery College of Medicine, Yeungnam University) ;
  • Kim, Sang-Woo (Department of Neurosurgery College of Medicine, Yeungnam University) ;
  • Kim, Oh-Lyong (Department of Neurosurgery College of Medicine, Yeungnam University) ;
  • Kim, Seong-Ho (Department of Neurosurgery College of Medicine, Yeungnam University)
  • Published : 2008.02.29
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Abstract

Objective: The purpose of this study is to identify the factors affecting the failure of trials (<50% pain reduction in pain for trial period) to improve success rate of spinal cord stimulation (SCS) trial. Methods: A retrospective review of the failed trials (44 patients, 36.1 %) among the patients (n=122) who underwent SCS trial between January 1990 and December 1998 was conducted. We reviewed the causes of failed trial stimulation, age, sex, etiology of pain, type of electrode, and third party support. Results: Of the 44 patients, 65.9% showed unacceptable pain relief in spite of sufficient paresthesia on the pain area with trial stimulation. Four of six patients felt insufficient paresthesia with stimulation had the lesions of the spinal cord. Seventy five percent of the patients experienced unpleasant or painful sensation during stimulation had allodynia dominant pain. Third-party involvement, sex, age and electrode type had no influence on the outcome. Conclusion: We conclude that SCS trial is less effective for patients with neuropathic pain of cord lesions, postherpetic neuropathy or post-amputation state. Further, patients with allodynia dominant pain can feel unpleasant or painful during trial stimulation.

Keywords

References

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