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Epidural spinal cord stimulation for neuropathic pain: a neurosurgical multicentric Italian data collection and analysis

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Abstract

Background

Spinal cord stimulation (SCS) is a technique used worldwide to treat several types of chronic neuropathic pain refractory to any conservative treatment. The aim of this data collection is to enforce evidence of SCS effectiveness on neuropathic chronic pain reported in the literature and to speculate on the usefulness of the trial period in determining the long–term efficacy. Moreover, the very low percentage of undesired side effects and complications reported in our case series suggests that all implants should be performed by similarly well-trained and experienced professionals.

Method

A multicentric data collection on a common database from 11 Italian neurosurgical departments started 3 years ago. Two different types of electrodes (paddle or percutaneous leads) were used. Of 122 patients, 73 % (N = 89) were submitted to a trial period, while the remaining patients underwent the immediate permanent implant (N = 33). Statistical comparisons of continuous variables between groups were performed.

Results

Most of the patients (80 %) had predominant pain to their lower limbs, while only 17 % of patients had prevalent axial pain. Significant reduction in pain, as measured by variation in visual analogue scale (VAS) score, was observed at least 1 year after implantation in 63.8 % of the cases, 59.5 % of patients who underwent a test trial and 71.4 % of patients who underwent permanent implant at once. No statistical differences were found between the lower-limb pain group and the axial pain group.

Conclusions

No relevant differences in long-term outcomes were observed in previously tested patients compared with patients implanted at once. Through this analysis we hope to recruit new centres, to give more scientific value to our results.

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Acknowledgments

Medtronic Italia provided technical support in terms of national data repository for data collection, and statistical analysis. No financial support was given to any author.

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Neurosurgery, IRCCS San Raffaele Hospital, Via Olgettina 60 Segrate, Milan, Italy

    Elena Virginia Colombo, Carlo Mandelli & Pietro Mortini

  2. Department of Neurosurgery, IRCCS C. Besta Neurological Foundation, Milan, Italy

    Giuseppe Messina & Ivano Dones

  3. Department of Neurosurgery, Valtellina and Valchiavenna Hospital, Sondalo, Italy

    Nicola De Marco

  4. Department of Neurosurgery, Papa Giovanni XXIII Hospital, Bergamo, Italy

    Roberto Donati

  5. Department of Neurosurgery, IGEA Clinic, Milan, Italy

    Claudio Irace

  6. Department of Neurosurgery, San Gerardo Hospital, Monza, Italy

    Andrea Landi

  7. Department of Neurosurgery, Campanella Foundation, Catanzaro, Italy

    Angelo Lavano

  8. Department of Neurosurgery, Spedali Civili Hospital, Brescia, Italy

    Massimo Mearini

  9. Department of Neurosurgery, Poliambulanza Foundation, Brescia, Italy

    Stefano Podetta

  10. Department of Neurosurgery, IRCCS Galeazzi Hospital, Milan, Italy

    Domenico Servello & Edvin Zekaj

  11. Department of Neurosurgery, Istituti Ospitalieri Hospital, Cremona, Italy

    Carlo Valtulina

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  1. Elena Virginia Colombo
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Correspondence to Elena Virginia Colombo.

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Colombo, E.V., Mandelli, C., Mortini, P. et al. Epidural spinal cord stimulation for neuropathic pain: a neurosurgical multicentric Italian data collection and analysis. Acta Neurochir 157, 711–720 (2015). https://doi.org/10.1007/s00701-015-2352-5

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  • DOI: https://doi.org/10.1007/s00701-015-2352-5

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