[Treatment of chronic pain of the musculoskeletal system by epidural stimulation].
In order to reduce refractory chronic pain of the musculoskeletal system, the orthopedic surgeon can stimulate electrically the peripheral nerves or the posterior funiculi of the spinal cord (epidural neurostimulation). The authors specify their current indications for epidural stimulation in the treatment of such painful diseases: radicular pain caused by arachnoepidurites, sequelae of trauma inflicted to the spine and medulla; postoperative lomboradicular pain of mixed source, and distal lesions of the plexus brachialis. The indication for an implant stems from a rigorous strategy which requires more particularly that pain regress by more than 50% under transcutaneous neurostimulation applied for a period of least one month and that the psychological and spinal-cerebral integrity be verified. The surgical procedure comprises two stages: first, positioning of an epidural electrode and, then, insertion of a totally implantable multiprogrammable radiostimulator. Judging from a prospective assessment of 20 cases of postoperative lumbar arachnoepiduritis treated in this way, the results are considered quite encouraging.
Husson
J L
JL
Service d'Orthopédie-Traumatologie A, Hôtel-Dieu, Rennes.
Meadeb
J
J
Eudier
F
F
Masse
A
A
D015360:Analgesia, Epidural / Q000379:methods*; D001100:Arachnoiditis / Q000628:therapy; D002908:Chronic Disease; D004599:Electric Stimulation Therapy / Q000379:methods*; D006801:Humans; D009141:Musculoskeletal System; D009443:Neuritis / Q000628:therapy; D059408:Pain Management; D012189:Retrospective Studies; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*
Traitement des douleurs chroniques de l'appareil locomoteur par neurostimulation épidurale.