[Spinal cord electric stimulation. Treatment of serious chronic ischemic syndromes of the limbs]. / La stimolazione elettrica del midollo spinale. Trattamento delle sindromi ischemiche croniche severe degli arti.

BACKGROUND: Aim of this study is to estimate the effectiveness of epidural electric stimulation of spinal cord for the treatment of patients with severe peripheral chronic arteriopathy who can't be surgically treated or when surgical therapy failed. METHODS: A retrospective study was carried out on 18 patients with peripheral chronic arteriopathy at clinical stage I of Fontaine classification; average age was of 60.08 years an they had rest pain and dystrophic lesions. Five patients couldn't be surgically treated. Stimulator catheter was placed in the epidural space and its action was evaluated studying lesion demarcation and pain resolution. RESULTS: In 16 cases there was a good pain control and in 14 patients lesion demarcation, while in 4 cases there was cases no improvement and amputation was necessary. CONCLUSIONS: Epidural electric stimulation of spinal cord is a valid treatment in selected patients for ischemia pain control and limb savage.

Possibilities at present for the application of lumbar sympathectomy in chronic occlusive arterial disease of the lower limbs.

BACKGROUND: Research on the limitations of the validity of lumbar sympathectomy in surgical treatment of lower limb occlusive arterial disease is still of great interest today. METHODS: Our study deals with 385 patients who underwent the surgical removal of a segment which includes the 2nd and the 3rd ganglion of the lumbar sympathetic chain in the period between the month of January 1989 and the month of December 1998. RESULTS: Results were good in 63.6% of patients and stationary in 10.53% of cases; in 26% of cases lumbar sympathectomy was not valid. CONCLUSIONS: Satisfactory results were recorded, as will be shown in this text, on patients experiencing a period of rest pain, patients with ischaemic dystrophic lesions and those with very advanced intermittent claudication equally favourable results were seen in diabetic patients.