Long-term Effect and Predictive Factors of Motor Cortex and Spinal Cord Stimulation for Chronic Neuropathic Pain
| Autor: | Hiroshi Noda, Yasukazu Kajita, Daisuke Nakatsubo, Satoshi Maesawa, Kosuke Aoki, Takafumi Tanei, Toshihiko Wakabayashi, Norimoto Nakahara, Shigenori Takebayashi |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Visual analogue scale Deep Brain Stimulation Pain relief Spinal cord stimulation 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Neuromodulation medicine Humans Term effect Aged Retrospective Studies Aged 80 and over neuropathic pain Spinal Cord Stimulation long-term business.industry Motor Cortex Motor cortex stimulation Middle Aged humanities medicine.anatomical_structure Treatment Outcome Anesthesia Neuropathic pain neuromodulation Neuralgia Surgery Female Original Article Neurology (clinical) Chronic Pain business 030217 neurology & neurosurgery Motor cortex motor cortex stimulation |
| Zdroj: | Neurologia medico-chirurgica |
| ISSN: | 1349-8029 |
| Popis: | The long-term effects of motor cortex stimulation (MCS) and spinal cord stimulation (SCS) remain unknown. To identify the long-term effects after MCS or SCS and determine any associated predictive factors for the outcomes. Fifty patients underwent MCS (n = 15) or SCS (n = 35) for chronic neuropathic pain. The degree of pain was assessed preoperatively, at 1, 6, and 12 months after surgery, and during the time of the last follow-up using Visual Analog Scale (VAS). Percentage of pain relief (PPR) was calculated, with "long-term effect" defined as PPR ≥ 30% and the presence of continued pain relief over 12 months. Outcomes were classified into excellent (PPR ≥ 70%) and good (PPR 30-69%) sub-categories. Long-term effects of MCS and SCS were observed in 53.3% and 57.1% of the patients, respectively. There were no predictive factors of long-term effects identified for any of the various preoperative conditions. However, the VAS at 1 month after surgery was significantly associated with the long-term effects in both MCS and SCS. All patients with an excellent outcome at 1 month after the surgery continued to exhibit these effects. In contrast, patients with the good outcome at 1 month exhibited a significant decrease in the effects at 6 months after surgery. The long-term effects of MCS and SCS were approximately 50% during the more than 8.5 and 3.5 years of follow-up, respectively. The VAS at 1 month after surgery may be a postoperative predictor of the long-term effects for both MCS and SCS. |
| Databáze: | OpenAIRE |
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