Journal of Korean Neurosurgical Society

  • 제65권2호
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  • Pages.276-286
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  • 2022
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Clinical Outcomes after Spinal Cord Stimulation According to Pain Characteristics

  • Ha, Jong-Ho (Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University) ;
  • Huh, Ryoong (Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Kim, Shin-Gyeom (Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Soonchunhyang University) ;
  • Im, Soo-Bin (Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University) ;
  • Jeong, Je Hoon (Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University) ;
  • Hwang, Sun-Chul (Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University) ;
  • Shin, Dong-Seong (Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University) ;
  • Kim, Bum-Tae (Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University) ;
  • Chung, Moonyoung (Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University)
  • 투고 : 2021.06.12
  • 심사 : 2021.08.25
  • 발행 : 2022.03.01
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초록

Objective : Spinal cord stimulation (SCS) is an effective treatment for chronic neuropathic pain. However, its clinical efficacy in regard to specific types of pain has not been well studied. The primary objective of this study was to retrospectively analyze the clinical outcomes of paddle-type SCS according to the type of neuropathic pain. Methods : Seventeen patients who underwent paddle-lead SCS at our hospital were examined. Clinical outcomes were evaluated pre- and postoperatively (3 months, 1 year, and last follow-up) using the Neuropathic Pain Symptom Inventory (NPSI). The NPSI categorizes pain as superficial, deep, paroxysmal, evoked, or dysesthesia and assess the duration of the pain (pain time score). Changes in NPSI scores were compared with change in Visual analogue scale (VAS) scores. Results : After SCS, the pain time score improved by 45% (independent t-test, p=0.0002) and the deep pain score improved by 58% (independent t-test, p=0.001). Improvements in the pain time score significantly correlated with improvements in the VAS score (r=0.667, p=0.003, Spearman correlation). Additionally, the morphine milligram equivalent value was markedly lower after vs. before surgery (~49 mg, pared t-test, p=0.002). No preoperative value was associated with clinical outcome. Conclusion : The NPSI is a useful tool for evaluating the therapeutic effects of SCS. Chronic use of a paddle-type spinal cord stimulation improved the deep pain and the pain time scores.

키워드

과제정보

This work was supported by the National Research Foundation of Korea (NRF) grant, funded by the Korean Ministry of Science and ICT (No. 2019R1G1A1100439). This work was also supported by the Soonchunhyang University Research Fund.

참고문헌

  1. Aiudi CM, Dunn RY, Burns SM, Roth SA, Opalacz A, Zhang Y, et al. : Loss of efficacy to spinal cord stimulator therapy: clinical evidence and possible causes. Pain Physician 20 : E1073-E1080, 2017
  2. Apkarian AV, Baliki MN, Geha PY : Towards a theory of chronic pain. Prog Neurobiol 87 : 81-97, 2009 https://doi.org/10.1016/j.pneurobio.2008.09.018
  3. Baron R, Binder A, Wasner G : Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment. Lancet Neurol 9 : 807-819, 2010 https://doi.org/10.1016/S1474-4422(10)70143-5
  4. Basbaum AI, Bautista DM, Scherrer G, Julius D : Cellular and molecular mechanisms of pain. Cell 139 : 267-284, 2009 https://doi.org/10.1016/j.cell.2009.09.028
  5. Bouhassira D, Attal N, Fermanian J, Alchaar H, Gautron M, Masquelier E, et al. : Development and validation of the neuropathic pain symptom inventory. Pain 108 : 248-257, 2004 https://doi.org/10.1016/j.pain.2003.12.024
  6. Bouhassira D, Wilhelm S, Schacht A, Perrot S, Kosek E, Cruccu G, et al. : Neuropathic pain phenotyping as a predictor of treatment response in painful diabetic neuropathy: data from the randomized, double-blind, COMBO-DN study. Pain 155 : 2171-2179, 2014 https://doi.org/10.1016/j.pain.2014.08.020
  7. Bushnell MC, Ceko M, Low LA : Cognitive and emotional control of pain and its disruption in chronic pain. Nat Rev Neurosci 14 : 502-511, 2013 https://doi.org/10.1038/nrn3516
  8. Cameron T : Safety and efficacy of spinal cord stimulation for the treatment of chronic pain: a 20-year literature review. J Neurosurg 100(3 Suppl Spine) : 254-267, 2004 https://doi.org/10.3171/spi.2004.100.3.0254
  9. Cohen SP, Mao J : Neuropathic pain: mechanisms and their clinical implications. BMJ 348 : g2323, 2014 https://doi.org/10.1136/bmj.g2323
  10. Crawford B, Bouhassira D, Wong A, Dukes E : Conceptual adequacy of the neuropathic pain symptom inventory in six countries. Health Qual Life Outcomes 6 : 62, 2008 https://doi.org/10.1186/1477-7525-6-62
  11. Deer TR, Skaribas IM, Haider N, Salmon J, Kim C, Nelson C, et al. : Effectiveness of cervical spinal cord stimulation for the management of chronic pain. Neuromodulation 17 : 265-271; discussion 271, 2014 https://doi.org/10.1111/ner.12119
  12. Frey ME, Manchikanti L, Benyamin RM, Schultz DM, Smith HS, Cohen SP : Spinal cord stimulation for patients with failed back surgery syndrome: a systematic review. Pain Physician 12 : 379-397, 2009
  13. Gee L, Smith HC, Ghulam-Jelani Z, Khan H, Prusik J, Feustel PJ, et al. : Spinal cord stimulation for the treatment of chronic pain reduces opioid use and results in superior clinical outcomes when used without opioids. Neurosurgery 84 : 217-226, 2019 https://doi.org/10.1093/neuros/nyy065
  14. Grider JS, Manchikanti L, Carayannopoulos A, Sharma ML, Balog CC, Harned ME, et al. : Effectiveness of spinal cord stimulation in chronic spinal pain: a systematic review. Pain Physician 19 : E33-E54, 2016
  15. Holsheimef J, Barolat G : Spinal geometry and paresthesia coverage in spinal cord stimulation. Neuromodulation 1 : 129-136, 1998 https://doi.org/10.1111/j.1525-1403.1998.tb00006.x
  16. Ikemoto T, Hayashi K, Shiro Y, Arai YC, Marcuzzi A, Costa D, et al. : A systematic review of cross-cultural validation of the pain catastrophizing scale. Eur J Pain 24 : 1228-1241, 2020 https://doi.org/10.1002/ejp.1587
  17. Kemler MA, De Vet HC, Barendse GA, Van Den Wildenberg FA, Van Kleef M : The effect of spinal cord stimulation in patients with chronic reflex sympathetic dystrophy: two years' follow-up of the randomized controlled trial. Ann Neurol 55 : 13-18, 2004 https://doi.org/10.1002/ana.10996
  18. Kemler MA, de Vet HC, Barendse GA, van den Wildenberg FA, van Kleef M : Spinal cord stimulation for chronic reflex sympathetic dystrophy- -five-year follow-up. N Engl J Med 354 : 2394-2396, 2006 https://doi.org/10.1056/NEJMc055504
  19. Kumar K, Hunter G, Demeria D : Spinal cord stimulation in treatment of chronic benign pain: challenges in treatment planning and present status, a 22-year experience. Neurosurgery 58 : 481-496; discussion 481-496, 2006 https://doi.org/10.1227/01.NEU.0000192162.99567.96
  20. Kumar K, Taylor RS, Jacques L, Eldabe S, Meglio M, Molet J, et al. : Spinal cord stimulation versus conventional medical management for neuropathic pain: a multicentre randomised controlled trial in patients with failed back surgery syndrome. Pain 132 : 179-188, 2007 https://doi.org/10.1016/j.pain.2007.07.028
  21. Kumar K, Taylor RS, Jacques L, Eldabe S, Meglio M, Molet J, et al. : The effects of spinal cord stimulation in neuropathic pain are sustained: a 24-month follow-up of the prospective randomized controlled multicenter trial of the effectiveness of spinal cord stimulation. Neurosurgery 63 : 762-770; discussion 770, 2008 https://doi.org/10.1227/01.NEU.0000325731.46702.D9
  22. Kumar K, Rizvi S : Cost-effectiveness of spinal cord stimulation therapy in management of chronic pain. Pain Med 14 : 1631-1649, 2013 https://doi.org/10.1111/pme.12146
  23. Kupers RC, Van den Oever R, Van Houdenhove B, Vanmechelcn W, Hepp B, Nuttin B, et al. : Spinal cord stimulation in Belgium: a nationwide survey on the incidence, indications and therapeutic efficacy by the health insurer. Pain 56 : 211-216, 1994 https://doi.org/10.1016/0304-3959(94)90096-5
  24. Light AR : Normal anatomy and physiology of the spinal cord dorsal horn. Appl Neurophysiol 51 : 78-88, 1988
  25. Main CJ : Pain assessment in context: a state of the science review of the McGill pain questionnaire 40 years on. Pain 157 : 1387-1399, 2016 https://doi.org/10.1097/j.pain.0000000000000457
  26. Meyerson BA, Linderoth B : Mechanisms of spinal cord stimulation in neuropathic pain. Neurol Res 22 : 285-292, 2000 https://doi.org/10.1080/01616412.2000.11740672
  27. Nielsen S, Degenhardt L, Hoban B, Gisev N : A synthesis of oral morphine equivalents (OME) for opioid utilisation studies. Pharmacoepidemiol Drug Saf 25 : 733-737, 2016 https://doi.org/10.1002/pds.3945
  28. Nissen M, Ikaheimo TM, Huttunen J, Leinonen V, von Und Zu Fraunberg M : Long-term outcome of spinal cord stimulation in failed back surgery syndrome: 20 years of experience with 224 consecutive patients. Neurosurgery 84 : 1011-1018, 2019 https://doi.org/10.1093/neuros/nyy194
  29. North RB, Kidd DH, Farrokhi F, Piantadosi SA : Spinal cord stimulation versus repeated lumbosacral spine surgery for chronic pain: a randomized, controlled trial. Neurosurgery 56 : 98-106; discussion 106-107, 2005 https://doi.org/10.1227/01.neu.0000144839.65524.e0
  30. North RB, Kidd DH, Petrucci L, Dorsi MJ : Spinal cord stimulation electrode design: a prospective, randomized, controlled trial comparing percutaneous with laminectomy electrodes: part II-clinical outcomes. Neurosurgery 57 : 990-996; discussion 990-996, 2005 https://doi.org/10.1227/01.NEU.0000180030.00167.b9
  31. North RB, Kidd DH, Wimberly RL, Edwin D : Prognostic value of psychological testing in patients undergoing spinal cord stimulation: a prospective study. Neurosurgery 39 : 301-310; discussion 310-311, 1996 https://doi.org/10.1097/00006123-199608000-00013
  32. Olson KA, Bedder MD, Anderson VC, Burchiel KJ, Villanueva MR : Psychological variables associated with outcome of spinal cord stimulation trials. Neuromodulation 1 : 6-13, 1998 https://doi.org/10.1111/j.1525-1403.1998.tb00025.x
  33. Ossipov MH, Dussor GO, Porreca F : Central modulation of pain. J Clin Invest 120 : 3779-3787, 2010 https://doi.org/10.1172/JCI43766
  34. Padua L, Briani C, Jann S, Nobile-Orazio E, Pazzaglia C, Morini A, et al. : Validation of the Italian version of the neuropathic pain symptom inventory in peripheral nervous system diseases. Neurol Sci 30 : 99-106, 2009 https://doi.org/10.1007/s10072-009-0025-y
  35. Patel SK, Gozal YM, Saleh MS, Gibson JL, Karsy M, Mandybur GT : Spinal cord stimulation failure: evaluation of factors underlying hardware explantation. J Neurosurg Spine 32 : 23-30, 2020 https://doi.org/10.3171/2019.7.SPINE19437
  36. Rudd RA, Seth P, David F, Scholl L : Increases in Drug and opioid-involved overdose deaths - United States, 2010-2015.M M W R M o r b Mortal Wkly Rep 65 : 1445-1452, 2016
  37. Sankarasubramanian V, Harte SE, Chiravuri S, Harris RE, Brummett CM, Patil PG, et al. : Objective measures to characterize the physiological effects of spinal cord stimulation in neuropathic pain: a literature review. Neuromodulation 22 : 127-148, 2019 https://doi.org/10.1111/ner.12804
  38. Schu S, Slotty PJ, Bara G, von Knop M, Edgar D, Vesper J : A prospective, randomised, double-blind, placebo-controlled study to examine the effectiveness of burst spinal cord stimulation patterns for the treatment of failed back surgery syndrome. Neuromodulation 17 : 443-450, 2014 https://doi.org/10.1111/ner.12197
  39. Simopoulos T, Sharma S, Wootton RJ, Orhurhu V, Aner M, Gill JS : Discontinuation of chronic opiate therapy after successful spinal cord stimulation is highly dependent upon the daily opioid dose. Pain Pract 19 : 794-799, 2019 https://doi.org/10.1111/papr.12807
  40. Solaro C, Cella M, Signori A, Martinelli V, Radaelli M, Centonze D, et al. : Identifying neuropathic pain in patients with multiple sclerosis: a cross-sectional multicenter study using highly specific criteria. J Neurol 265 : 828-835, 2018 https://doi.org/10.1007/s00415-018-8758-2
  41. Sommer C, Richter H, Rogausch JP, Frettloh J, Lungenhausen M, Maier C : A modified score to identify and discriminate neuropathic pain: a study on the German version of the Neuropathic Pain Symptom Inventory (NPSI). BMC Neurol 11 : 104, 2011 https://doi.org/10.1186/1471-2377-11-104
  42. Strang J, Volkow ND, Degenhardt L, Hickman M, Johnson K, Koob GF, et al. : Opioid use disorder. Nat Rev Dis Primers 6 : 3, 2020 https://doi.org/10.1038/s41572-019-0137-5
  43. Wiech K : Deconstructing the sensation of pain: the influence of cognitive processes on pain perception. Science 354 : 584-587, 2016 https://doi.org/10.1126/science.aaf8934
  44. Wolter T : Spinal cord stimulation for neuropathic pain: current perspectives. J Pain Res 7 : 651-663, 2014 https://doi.org/10.2147/JPR.S37589