Main Article Content

Paul Beeson
Senior Lecturer
United Kingdom
Biography
Robert Ashford
Professor
United Kingdom
Biography
Jon Raphael
Professor
United Kingdom
Biography
Vol. 2 No. 1 (2016), Original Articles, pages 22-30
DOI: https://doi.org/10.17979/ejpod.2016.2.1.1502
Submitted: Mar 27, 2016 Accepted: May 5, 2016 Published: May 28, 2016
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Abstract

Background/ Aim:

In cases of complex regional pain syndrome where conservative treatment is unsuccessful in controlling neuropathic foot pain spinal cord stimulation may be considered. To our knowledge there have been no such cases reported in the foot & ankle literature. The aim of the study was to establish useful information that may supplement our understanding of this complex multifactorial problem and help to inform future management of similar cases.

 

Materials and method:

A case series study was undertaken to investigate the use of spinal cord stimulation in the management of neuropathic foot pain using five cases with complex regional pain syndrome (type I).

Results:

Reduced pain following spinal cord stimulation was reported. The interval between diagnosis and commencement of spinal cord stimulation was variable between cases and maybe responsible for differing levels and timing of pain relief experienced.

Conclusion:

Careful preoperative diagnosis, robust patient selection and close postoperative monitoring are vital for a successful outcome. The small sample size and potential for bias, limit the generalizability to a larger population. A larger study is therefore indicated to expand upon preliminary findings.

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References

Freynhagen R, Bennett MI. Diagnosis and management of neuropathic pain. BMJ 2009. 339:b3002. doi: 10.1136/bmj.b3002P. O’Hara, Pain Management for Health Professional, 1st ed. London, Chapman & Hall. 1996, p. 102-6.

Treede RD, Jensen TS, Campbell JN et al. Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology 2008; 70:1630-1635.

Baron R. Mechanisms of disease: neuropathic pain: a clinical perspective. Nat Clin Pract Neurol 2006;2:95-106.

Scholz J, Woolf CJ. The neuropathic pain triad: neurons, immune cells 3 and glia. Nat Neurosci 2007;10:1361-1368.

Kavar B, Rosenfeld JV, Hutchinson A. The efficacy of spinal cord stimulation for chronic pain, J Clin Neuroscience 2000;7:409-13.

Mailis-Gagnon A, Furlan AD, Sandoval JA et al. Spinal cord stimulation for chronic pain. Cochrane Database of Systematic Reviews 2004; 3 CD003783.

Kumar K, Taylor R, Jacques L. et al. Spinal cord stimulation versus conventional medical management for neuropathic pain: a multi-center randomized controlled trial in patients with failed back surgery syndrome. Pain 2007;132:179-188.

Kumar K, Taylor RS, Jacques L 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 2008;63:762–770.

Raphael JH, Mutagi HS, Kapur S. Spinal cord stimulation and its anaesthetic implication. Continuing Education in Anaesthesia Critical Care & Pain 2009. doi:10.1093/bjaceaccp/mkp009.

Zigmond AS, Snaith RP. The hospital anxiety and depression scale, Acta Psychiatrica Scandinavica 1983;67:361–370.

Bjelland I, Dahl AA, Haug TT et al. The validity of the Hospital Anxiety and Depression Scale. An up-dated literature review. J Psychosom Res 2002;52: 69–77.

Kim DD, Vakharyia R, Kroll HR et al. Rates of lead migration and stimulation loss in spinal cord stimulation: A retrospective comparison of laminotomy versus percutaneous implantation. Pain Physician 2011;14: 513-24.

Kim TH, Lee PB, Son, HM et al. Spontaneous lead breakage in implanted implanted spinal cord stimulation systems. Korean J Pain 2010;23:78-81.

Hylands-White N, Duarte RV, Beeson P et al. Electroencephalographic evoked pain response is suppressed by spinal cord stimulation in complex regional pain syndrome: a case report. J Clin Monit Comput; 2015; 1-4.