Abstracts from the Neuromodulation Society of the UK & Ireland 2010 Annual Scientific Meeting October 4-5, 2010 Leeds, UK

摘要

Background and Aims: Spinal cord stimulation (SCS) can be an effective treatment in pharmacologically resistant neuropathic pain (NeP) conditions, but in 30% to 50% of well-selected patients SCS trials may fail to produce satisfactory pain relief (1-5), and a relatively large group of patients experience late failure of SCS (6). The use of intrathecal baclofen (ITB) for pain therapy has been reported by many authors (7-10). Lind etal. in 2008 (11) found that ITB both enhances the analgesic effect of SCS and can be offered as single therapy in selective cases in which SCS is con-traindicated or fails to improve pain. Schechtmann etal in 2010 (12) reported 32% and 82% pain reduction (stimulation off at baseline) at seven months in two SCS patients implanted with ITB pumps. The aim of this study is to evaluate the analgesic effect of ITB in nine patients suffering from NeP with implanted pumps. All had been trialled with baclofen, morphine (+-) bupivacaine, and placebo.Methods: In this retrospective study the medical notes of nine patients with NeP treated with ITB were reviewed. Data obtained included age, pain diagnosis and duration, physical performance measures, disability scores, patient global impression of change, patient satisfaction, baclofen doses, oral analgesics, and complications. Average pain (AP) and worst pain (WP) scores (0-10 NRS) were identified at three time points: baseline, trial and follow-up.Results: Five patients had previously experienced late failure of SCS. In these patients, the mean AP and WP rating at baseline (stimulation on) were 5.6 (4-7) and 8.4 (7-10). The mean reduction of AP and WP on optimal trial dose was 2.4 (1 -5) and 3 (0-6), respectively. Mean reduction from baseline of AP and WP at follow-up (mean = 32 m (3-97 m)) was 0.4 (-1-2) and 0.8 (-1-3). Mean trial dose was 79 |ig/d increasing to 128 u.g/d at follow-up.In the remaining four patients, the mean AP and WP rating at baseline were 7.25 (4-8) and 9.5 (8-10). Mean reducti...