RESUMO
Objective. To assess the effect of spinal cord stimulation in patients with severe, inoperable peripheral vascular disease, and uncontrolled pain. Patients and methods. A case study of 20 patients with end-stage peripheral vascular disease, either Fontaine Class 3 or 4 limb ischemia. All 20 patients implanted with spinal cord stimulation devices with follow-up from one to five years (mean, 32 months) performed in a multidisciplinary pain treatment center. Results. In the 20 patients implanted with a spinal cord stimulator for peripheral vascular disease, overall there was 75% limb salvage; with Fontaine Class 3 patients there was 86% and with Fontaine Class 4 patients, 69% limb salvage of the treated limbs. Conclusions. Twenty patients with end-stage peripheral vascular disease were implanted with spinal cord stimulators and followed for five years, until amputation or end of life, showing excellent results for limb salvage and minimal complications. The current literature regarding the use of spinal cord stimulation for peripheral vascular disease is reviewed, supporting its benefit for limb salvage and pain relief.
RESUMO
For patients with peripheral vascular disease that have exhausted all means for surgical repair, spinal cord stimulation is an alternative treatment that could offer them significant pain relief or possibly delay the need for limb amputation. Spinal cord stimulation (SCS) has proven to offer many of these patients a return to a more normal lifestyle by relieving pain to such a degree that their mobility is improved. In addition, increases in blood flow to the affected extremity have helped to improve overall foot salvage. Since SCS is minimally invasive and has few reported complications, it is a viable alternative for patients with multiple health risks, and with proper patient selection and early referral, it can reduce health care costs in many cases.
