An: 2024, Nr.2, Articol Nr. 1

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      EFFICACY OF THE SPINAL CORD NEUROSTIMULATION IMPLANT ACCORDING TO THE ANATOMICAL LOCATION OF THE STIMULATION ELECTRODE IN PATIENTS WITH CHRONIC NEUROPATHIC PAIN – CLINICAL STUDY (Abstract): Chronic neuropathic pain secondary to previous surgery causes a significant decrease in quality of life. Objectives: This study aims to evaluate the effectiveness of spinal neurostimulator in patients with chronic neuropathic pain refractory to treatment. Methods: We analyzed the Visual Analogue Scale (VAS) pain score before and after spinal neurostimulator implantation, as well as the optimal anatomical location of the electrode, where the intensity of pain experienced by the patient is minimal. Results: This study included 60 eligible patients, with a mean age of 53.87 ± 12.033 years. The patients suffered between 1 and 9 spinal surgery prior to spinal implant, the most frequent cases (36.7%) having 3 prior interventions. In 26/60 (43.3%) cases, the neuropathic chronic pain started within the first year from the surgical intervention. Considering the causes of the neuropathic chronic pain, four main categories have been identified: herniated disk, lumbar stenosis, spondilolistezis, and spine fractures, as well as other pathologies. Before the implant, the highest mean VAS score was 10.00 in the cervical spinal region (C3) and thoracal region (D12). Patients showed a significant decrease of pain after the implant in the same regions, with a mean VAS score of 2.00. The pain intensity, determined by VAS score, was significantly reduced (p = 0.032) after implant, mainly when it registered high values (9 or 10). Conclusions: The results demonstrate that the spinal cord stimulator located in the cervical C3 and thoracal D12 is an effective therapeutic option for patients with chronic neuropathic pain refractory to treatment.

Key words: neuropathic chronic pain, spinal neurostimulation implant, electrode location, VAS pain score