Résumé
Methods@#A total of 24 patients with postsurgical chronic pain and/or numbness Numeric Rating Scale (NRS) scores of ≥4 were enrolled. All patients underwent spine or spinal cord surgery at Keio University Hospital and received daily administration of DLX for more than 3 months. The mean postoperative period before the first administration of DLX was 35.5±57.0 months. DLX was administered for more than 3 months at a dose of 20, 40, or 60 mg/day, and the degree of pain and numbness was evaluated using the NRS before administration and 3 months after administration. Effectiveness was defined as more than a 2-point decrease in the NRS score following administration. @*Results@#In terms of the type of symptoms, 15 patients experienced only numbness, eight experienced both pain and numbness, and one experienced only pain. Of the 24 patients, 19 achieved effective relief with DLX. DLX was effective for all patients with postsurgical chronic pain (n=9), and it reduced postsurgical chronic numbness in 18 of 23 patients. No significant difference was observed in background spinal disorders. DLX was not effective for five patients who complained only of postsurgical chronic numbness. @*Conclusions@#This study reports the effectiveness of DLX for postsurgical chronic neuropathic disorders. Although DLX reduced postsurgical chronic pain (efficacy rate=100%) and numbness (78.3%) in certain patients, further investigation is needed to determine its optimal use.
Résumé
Spinal cord stimulation (SCS) has been reported to be effective for complex regional pain syndrome (CRPS). This is a case report of a patient with CRPS who was successfully treated with a combination of temporary SCS lead placement and physical therapy. A 19-year-old man presented with severe pain for a few months since receiving plaster cast fixation as treatment for an ankle sprain injury at the previous hospital. At his first visit to our pain center, he could not walk without crutches because of severe pain accompanied by symptoms such as allodynia, decreased skin temperature, redness, edema, muscle weakness, and changes in the appearance of the affected area. The symptoms met the diagnostic criteria for CRPS. Temporary SCS lead placement was performed to alleviate the pain and peripheral circulatory disorder, along with physiotherapy to improve the flexibility and restore the normal appearance of the affected limb. The interdisciplinary treatment effectively improved our patient's leg edema and walking ability, which consequently led to pain relief.
Résumé
Spinal cord stimulation (SCS) has been reported to be effective for complex regional pain syndrome (CRPS). This is a case report of a patient with CRPS who was successfully treated with a combination of temporary SCS lead placement and physical therapy. A 19-year-old man presented with severe pain for a few months since receiving plaster cast fixation as treatment for an ankle sprain injury at the previous hospital. At his first visit to our pain center, he could not walk without crutches because of severe pain accompanied by symptoms such as allodynia, decreased skin temperature, redness, edema, muscle weakness, and changes in the appearance of the affected area. The symptoms met the diagnostic criteria for CRPS. Temporary SCS lead placement was performed to alleviate the pain and peripheral circulatory disorder, along with physiotherapy to improve the flexibility and restore the normal appearance of the affected limb. The interdisciplinary treatment effectively improved our patient's leg edema and walking ability, which consequently led to pain relief.