Dorsal spinal cord stimulation in the treatment of multiple sclerosis.
Previously published work indicated significant improvement in the symptoms of multiple sclerosis with dorsal spinal cord stimulation. In this study 23 patients with multiple sclerosis documented by history, examination, laboratory studies, and clinical course were treated with dorsal spinal cord stimulation and followed for 19 to 45 months (mean, 32 months). Pre- and postoperative clinical assessment was carried out using the Kurtzke Scale. Walking velocity, upper limb coordination, sphincter function, and sensory function were also evaluated quantitatively. No statistically significant objective improvement in any of these measures was demonstrated. Fifty per cent of the patients initially reported subjective symptomatic improvement, but this declined to 30% at last follow-up. Fifteen of 23 patients experienced complications related mainly to the hardware used and required a total of 21 subsequent operative procedures for correction of these complications. These results do not support the continued clinical use of dorsal spinal cord stimulation in the symptomatic treatment of multiple sclerosis.
D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D007422:Intestines / Q000503:physiopathology; D008297:Male; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011183:Postoperative Complications; D011712:Pyramidal Tracts / Q000503:physiopathology; D012023:Reflex, Monosynaptic; D013116:Spinal Cord; D001743:Urinary Bladder / Q000503:physiopathology