脊髓电刺激在疼痛治疗中的应用

目的报告我院自2000年9月至2004年10月4年中脊髓电刺激(spinal cord stimulation，SCS)在疼痛治疗中的效果。方法50例患有背部手术后疼痛综合征(failed back surgery syndrome)、复杂性局部疼痛综合征(complex regional pain syndrome，CRPS)、带状疱疹后神经痛或非特异性疼痛的患者接受了SCS治疗。硬膜外穿刺成功后将刺激电极置于硬膜外间隙，连接体外刺激器进行脊髓电刺激。结果31例永久性植入脊髓电刺激器的患者中，18例疼痛明显改善，9例轻度减轻，4例无效。其余19例则由于多种原因在试验性治疗后去除了刺激器。结论如果SCS试验有效，此法可用于背部手术后疼痛综合征、复杂性局部疼痛综合征以及神经源性疼痛如带状疱疹后神经痛。

Spinal cord stimulation in pain clinic

Objective The indications of spinal cord stimulation (SCS) are failed back surgery syndrome, complex regional pain syndrome (CRPS), chronic intractable angina, and pain and disability due to peripheral vascular disease. We investigated the efficacy of SCS in our hospital for 4 years from Sep. 2000 to Oct. 2004. Method We perform SCS trials in SO patients with failed back surgery syndrome, CRPS, and post herpetic neuralgia. An electrode was positioned in the posterior epidural space through a Tuohy needle and then connected to an external stimulator. Result Spinal cord stimulators were removed from 19 of the patients and permanently implanted in 31 patients. Of the patients with permanently implanted spinal cord stimulator, 4 of the patients failed to relieve pain and we removed SCS from them. 27 patients have permanent SCS, 18 of them patients had symptomatically improved significantly and 9 of them slightly impro-ved.Concluslon SCS can be done in the patients with failed back surgery syndrome, CRPS, and neuropathic pain such as post herpetic neuralgia if the SCS trials were successful.