3
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Neuroestimulación medular. Análisis de las indicaciones diagnósticas Translated title: Spinal cord stimulation. Analysis of diagnostic indications

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          RESUMEN Introducción: La neuroestimulación medular (NM) es una forma de tratamiento del dolor crónico que ha demostrado su efectividad en pacientes que han respondido mal a otras terapias. Las indicaciones actuales para los dispositivos de NM son muy variadas. El objetivo de nuestro estudio es analizar las indicaciones diagnósticas de la terapia con NM durante los últimos 5 años en nuestro hospital, conocer cuáles son las causas de dolor más frecuentes para la indicación del implante del dispositivo y qué porcentaje de mejoría presentan los pacientes, así como estudiar la relación con el género y la edad. Material y métodos: Se trata de un estudio observacional, descriptivo y retrospectivo. Los pacientes fueron identificados desde el registro de actividad quirúrgica de la Unidad del Dolor del Hospital General de Valencia. Resultados: El número final de pacientes incluidos fue de 179. El síndrome de cirugía fallida de espalda (SCFE) fue la indicación diagnóstica en 112 pacientes (62,57 %). La media del porcentaje de mejoría descrita por los pacientes tras el implante del NM fue de 47,99 ± 27,3 %. No se observaron diferencias en la mejoría respecto a la edad o el género. Discusión: A pesar de la variabilidad de diagnósticos en los que puede estar indicada esta terapia, es destacable que en más de la mitad de los casos la indicación es por SCFE.

          Translated abstract

          ABSTRACT Introduction: Spinal cord stimulation (SCS) is a form of chronic pain treatment that has been shown to be effective in patients who have responded poorly to other therapies. The current indications for SCS devices are very varied. The aim of our study is to analyze the diagnostic indications of SCS therapy during the last 5 years in our hospital, to know the most frequent causes of pain for the indication of the implant of the device and what percentage of improvement patients present, as well as to study the relationship with gender and age. Material and methods: This is an observational, descriptive, retrospective study. The patients were identified from the surgical activity register of the Pain Unit of the General Hospital of Valencia. Results: The final number of patients included was 179. The Failed back surgery syndrome (FBSS) was the diagnostic indication in 112 patients (62.57 %). The mean percentage of improvement described by the patients after the SCS implant was 47.99 ± 27.3 %. There were no differences in the improvement with respect to age or gender. Discussion: In spite of the variability of diagnoses in which this therapy may be indicated, it is noteworthy that in more than half of the cases the indication is by FBSS.

          Related collections

          Most cited references15

          • Record: found
          • Abstract: found
          • Article: not found

          The clinical importance of changes in the 0 to 10 numeric rating scale for worst, least, and average pain intensity: analyses of data from clinical trials of duloxetine in pain disorders.

          Data on 1,700 patients pooled from 5 randomized, placebo-controlled duloxetine studies (3 in diabetic peripheral neuropathic pain and 2 in fibromyalgia) were analyzed to determine clinically important differences (CIDs) in the 0 to 10 Numeric Rating Scale-Pain Intensity (NRS-PI) for patient-reported "worst" and "least" pain intensity while validating the previously published level for "average" pain. The correspondence between the baseline-to-endpoint raw and percentage change in the NRS-PI for the worst, least, and average pain were compared to patients' perceived improvements at endpoint as measured by the 7-point Patient Global Impression of Improvement (PGI-I) scales. Stratification by baseline pain separated the raw but not the percent change scores. The PGI-I category of "much better" or above was our a priori definition of a CID. Cutoff points for the NRS-PI change scores were determined using a receiver operator curve analysis. A consistent relationship between the worst and average NRS-PI percent change and the PGI-I was demonstrated regardless of the study, pain type, age, sex, or treatment group with a reduction of approximately 34%. The least pain item CID was slightly higher at 41%. Raw change CID cutoff points were approximately -2, -2.5 and -3 for least, average, and worst pain respectively. We determined an anchor-based value for the change in the worst, least, and average pain intensity items of the Brief Pain Inventory that best represents a clinically important difference. Our findings support a standard definition of a clinically important difference in clinical trials of chronic-pain therapies. Copyright 2010 American Pain Society. Published by Elsevier Inc. All rights reserved.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Effectiveness of Spinal Cord Stimulation in Chronic Spinal Pain: A Systematic Review.

            Chronic neuropathic pain has been recognized as contributing to a significant proportion of chronic pain globally. Among these, spinal pain is of significance with failed back surgery syndrome (FBSS), generating considerable expense for the health care systems with increasing prevalence and health impact.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              Facet joint syndrome: from diagnosis to interventional management

              Abstract Low back pain (LBP) is the most common pain syndrome, and is an enormous burden and cost generator for society. Lumbar facet joints (FJ) constitute a common source of pain, accounting for 15–45% of LBP. Facet joint degenerative osteoarthritis is the most frequent form of facet joint pain. History and physical examination may suggest but not confirm facet joint syndrome. Although imaging (radiographs, MRI, CT, SPECT) for back pain syndrome is very commonly performed, there are no effective correlations between clinical symptoms and degenerative spinal changes. Diagnostic positive facet joint block can indicate facet joints as the source of chronic spinal pain. These patients may benefit from specific interventions to eliminate facet joint pain such as neurolysis, by radiofrequency or cryoablation. The purpose of this review is to describe the anatomy, epidemiology, clinical presentation, and radiologic findings of facet joint syndrome. Specific interventional facet joint management will also be described in detail. Teaching points • Lumbar facet joints constitute a common source of pain accounting of 15–45%. • Facet arthrosis is the most frequent form of facet pathology. • There are no effective correlations between clinical symptoms, physical examination and degenerative spinal changes. • Diagnostic positive facet joint block can indicate facet joints as the source of pain. • After selection processing, patients may benefit from facet joint neurolysis, notably by radiofrequency or cryoablation.
                Bookmark

                Author and article information

                Journal
                dolor
                Revista de la Sociedad Española del Dolor
                Rev. Soc. Esp. Dolor
                Inspira Network Group, S.L (Madrid, Madrid, Spain )
                1134-8046
                August 2020
                : 27
                : 4
                : 234-238
                Affiliations
                [3] orgnameUniversidad de Valencia orgdiv1Facultad de Medicina orgdiv2Unidad de Anestesia. Departamento de Cirugía España
                [2] Valencia orgnameHospital Universitario y Politécnico La Fe orgdiv1Departamento de Enfermería España
                [1] Valencia orgnameConsorcio Hospital General Universitario orgdiv1Departamento de Anestesia, Reanimación y Tratamiento del Dolor España
                Article
                S1134-80462020000400004 S1134-8046(20)02700400004
                10.20986/resed.2020.3777/2019
                d4b2a2ee-0161-4ebb-a9fd-8938da9ca705

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 07 July 2020
                : 04 November 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 18, Pages: 5
                Product

                SciELO Spain

                Categories
                Originales

                Spinal cord stimulation,failed back surgery syndrome,neuromodulation,chronic pain,Neuroestimulación medular,dolor crónico,neuromodulación,síndrome de cirugía fallida de espalda

                Comments

                Comment on this article