Isagulyan E., Shabalov V., Buklina S., Tomskiy À.
Burdenko Research Institute of Neurosurgery, Moscow, Russia
The research goal was to estimate efficacy of chronic electrostimulation (ES) of the spinal cord in cases with neurogenic pain syndromes.
Material. There were 17 cases (10 males and 7 females), aged 19-75 (a mean age of 47.5 years). All of them were treated for severe neurogenic pain syndromes in 2000-2005. The treatment consisted in implantation of systems for chronic ES of the spinal cord, carried out in accordance with conventional methods. Pathologic states, watched in the cases under discussion, were as follows: failed back surgery syndrome (FBSS) - 8, injuries of the spinal cord - 6, Leriche’s syndrome - 1, phantom pain syndrome - 1, other pathology - 1. The MATTRIX or Itrel III systems were implanted. Severity of pain syndrome was estimated on the basis of the visual-analog scale (VAS) and other scales.
Results. Reduction of pain syndrome of more than 75%, 50-75% and 30-50% from its initial level was considered to be an excellent, good or satisfactory result respectively. Lower indices were regarded to be a negative result. A follow-up (from 6 months up to 4.5 years, a mean period of 19 months) demonstrated the following results: excellent - 5, good - 8, satisfactory - 2 and poor - 2 cases. They were poor in the patients with FBSS, who had undergone more than 4 interventions on the spine before admission to us and had been ill for more than 5 years.
Conclusion. Chronic ES of the spinal cord is an effective method of treating severe pain syndromes. Repeated anatomic interventions, for example meningoradiculolysis, have a negative effect on prognosis of chronic ES of the spinal cord. Possible use of ES should be taken into account just at the moment of chronic pain syndrome diagnosis.