PMID- 38459710
OWN - NLM
STAT- Publisher
LR  - 20240309
IS  - 1533-2500 (Electronic)
IS  - 1530-7085 (Linking)
DP  - 2024 Mar 8
TI  - Clinical outcomes of spinal cord stimulation in patients with intractable leg 
      pain in Japan.
LID - 10.1111/papr.13363 [doi]
AB  - BACKGROUND: Neuromodulation through spinal cord stimulation (SCS) is a 
      therapeutic option for relieving leg pain and improving the chances of limb 
      salvage in patients with intractable chronic limb-threatening ischemia (CLTI); 
      however, there is no consensus on its indications. OBJECTIVE: The aim of this 
      study was to assess the clinical outcomes of SCS in patients with intractable leg 
      pain caused by various diseases treated in the department of cardiovascular 
      medicine in Japan. METHODS: This was a retrospective study of patients who 
      underwent SCS for pain management. Patients were considered eligible for the 
      therapy if they met the following criteria: (1) intractable leg pain (numerical 
      rating scale [NRS] score of 10), (2) no revascularization option, and (3) no 
      septicemia. RESULTS: Twenty patients (mean age: 77 years; men/women: 11/9) were 
      included in this study. The NRS score of the patients significantly reduced from 
      10 +/- 0 before procedure to 4 +/- 3 at discharge (p < 0.001). The clinical response 
      rate of the entire cohort was 65% (13/20) at 17 +/- 14 months after implantation; 
      however, patients with intractable CLTI showed a low response rate (45%), whereas 
      those with subacute limb ischemia showed a high response rate (100%). A 
      multivariable regression analysis showed that hemoglobin level was significantly 
      associated with treatment response, even after adjusting for age and sex 
      (p = 0.026). The area under the receiver operating characteristic curve for the 
      correlation between hemoglobin level (cutoff, 11.4 g/dL) and clinical response to 
      SCS was 0.824 (0.619-1). CONCLUSIONS: SCS can reduce clinical symptoms in 
      majority of patients with intractable leg pain. Although implantation of an SCS 
      device has been shown to improve microvascular perfusion insufficiency, the 
      correlation between hemoglobin level and the clinical effect of SCS indicates 
      that a preserved microcirculatory vascular bed is essential for the therapy to be 
      effective.
CI  - (c) 2024 The Authors. Pain Practice published by Wiley Periodicals LLC on behalf of 
      World Institute of Pain.
FAU - Ueno, Keisuke
AU  - Ueno K
AD  - Department of Cardiovascular Medicine, Yao Municipal Hospital, Yao, Osaka, Japan.
FAU - Tachibana, Koichi
AU  - Tachibana K
AD  - Department of Cardiovascular Medicine, Yao Municipal Hospital, Yao, Osaka, Japan.
FAU - Masunaga, Nobutaka
AU  - Masunaga N
AD  - Department of Cardiovascular Medicine, Yao Municipal Hospital, Yao, Osaka, Japan.
FAU - Shinoda, Yukinori
AU  - Shinoda Y
AD  - Department of Cardiovascular Medicine, Yao Municipal Hospital, Yao, Osaka, Japan.
FAU - Minamisaka, Tomoko
AU  - Minamisaka T
AD  - Department of Cardiovascular Medicine, Yao Municipal Hospital, Yao, Osaka, Japan.
FAU - Inui, Hirooki
AU  - Inui H
AD  - Department of Cardiovascular Medicine, Yao Municipal Hospital, Yao, Osaka, Japan.
FAU - Amiya, Ryohei
AU  - Amiya R
AD  - Department of Cardiovascular Medicine, Yao Municipal Hospital, Yao, Osaka, Japan.
FAU - Inoue, Soki
AU  - Inoue S
AD  - Department of Cardiovascular Medicine, Yao Municipal Hospital, Yao, Osaka, Japan.
FAU - Murakami, Arisa
AU  - Murakami A
AD  - Department of Cardiovascular Medicine, Yao Municipal Hospital, Yao, Osaka, Japan.
FAU - Hoshida, Shiro
AU  - Hoshida S
AUID- ORCID: 0000-0002-0268-9417
AD  - Department of Cardiovascular Medicine, Yao Municipal Hospital, Yao, Osaka, Japan.
LA  - eng
PT  - Journal Article
DEP - 20240308
PL  - United States
TA  - Pain Pract
JT  - Pain practice : the official journal of World Institute of Pain
JID - 101130835
SB  - IM
OTO - NOTNLM
OT  - chronic limb-threatening ischemia
OT  - hemoglobin level
OT  - spinal cord stimulation
EDAT- 2024/03/09 10:44
MHDA- 2024/03/09 10:44
CRDT- 2024/03/09 02:09
PHST- 2024/01/14 00:00 [revised]
PHST- 2023/11/09 00:00 [received]
PHST- 2024/02/29 00:00 [accepted]
PHST- 2024/03/09 10:44 [medline]
PHST- 2024/03/09 10:44 [pubmed]
PHST- 2024/03/09 02:09 [entrez]
AID - 10.1111/papr.13363 [doi]
PST - aheadofprint
SO  - Pain Pract. 2024 Mar 8. doi: 10.1111/papr.13363.