Emotional and psychosocial function after dorsal column spinal cord stimulator implantation: a systematic review and meta-analysis.

Autor:	Klasova J; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA., Hussain N; Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA., Umer I; Department of Anesthesiology, St Joseph's University Medical Center, Paterson, New Jersey, USA., Al-Hindawi A; Royal College of Surgeons in Ireland Medical University of Bahrain, Al Muharraq, Bahrain., ElSaban M; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA., Lahori S; Department of Hematology, Mayo Clinic, Rochester, Minnesota, USA., D'Souza RS; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA DSouza.Ryan@mayo.edu.
Jazyk:	angličtina
Zdroj:	Regional anesthesia and pain medicine [Reg Anesth Pain Med] 2024 Jun 27. Date of Electronic Publication: 2024 Jun 27.
DOI:	10.1136/rapm-2024-105523
Abstrakt:	Background: The efficacy of spinal cord stimulation (SCS) in chronic pain studies is traditionally assessed by pain scores, which do not reflect the multidimensional nature of pain perception. Despite the evidence of SCS's influence on emotional functioning comprehensive assessments of its effect remain lacking. Objective: To assess changes in emotional and psychosocial functioning in patients who underwent SCS implantation for chronic pain. Evidence Review: Ovid MEDLINE, EMBASE, PsychINFO, Cochrane CENTRAL and Scopus databases were searched for original peer-reviewed publications reporting emotional functioning after SCS. The primary outcomes were a pooled mean difference (MD) in anxiety, depression, global functioning, mental well-being and pain catastrophizing at 12 months. The Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) was used to determine the quality of evidence. Findings: Thirty-two studies were included in the primary analysis. Statistically significant improvements were observed in anxiety (MD -2.16; 95% CI -2.84 to -1.49; p<0.001), depression (MD -4.66; 95% CI -6.26 to -3.06; p<0.001), global functioning (MD 20.30; 95% CI 14.69 to 25.90; p<0.001), mental well-being (MD 4.95; 95% CI 3.60 to 6.31; p<0.001), and pain catastrophizing (MD -12.09; 95% CI -14.94 to -9.23; p<0.001). Subgroup analyses revealed differences in Global Assessment of Functioning and mental well-being based on study design and in depression based on waveform paradigm. Conclusion: The results highlight the statistically and clinically significant improvements in emotional and psychosocial outcomes in patients with chronic pain undergoing SCS therapy. However, these results need to be interpreted with caution due to the very low certainty of evidence per the GRADE criteria. Prospero Registration: CRD42023446326. Competing Interests: Competing interests: RDS received investigator-initiated grant funding pain to his institution from Nevro Corp and Saol Therapeutics. (© American Society of Regional Anesthesia & Pain Medicine 2024. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.)
Databáze:	MEDLINE
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