Spinal cord stimulation is effective in the management of reflex sympathetic dystrophy.
OBJECTIVE
The purpose of this study was to determine the efficacy of spinal cord stimulation (SCS) in patients with symptoms of reflex sympathetic dystrophy (RSD), a disabling clinical condition with significant consequences of morbidity and loss of productivity.


METHODS
We have used epidural SCS for pain control during the past 15 years. An analysis of our records revealed 12 consecutive patients diagnosed as having RSD before undergoing SCS. Eight of the 12 patients had undergone previous ablative sympathectomy. The mean age of the nine men and three women was 38.2 years. All suffered extremity injuries from a variety of causes.


RESULTS
All 12 patients experienced relief of pain after trial stimulation and had their systems permanently implanted. At an average of 41 months follow-up, all patients were using their stimulators regularly and only two were receiving adjunctive minor pain medication. The level of pain present pre- and postoperatively was determined by administering a modified McGill Pain Questionnaire and a visual analog scale to each patient. Eight patients reported excellent pain relief, and four patients described good results. Five minor complications occurred.


CONCLUSIONS
SCS is an effective treatment for the pain of RSD, including recurrent pain after ablative sympathectomy. The low morbidity of this procedure and its efficacy in patients with refractory pain related to RSD suggest that SCS is superior to ablative sympathectomy in the management of RSD.
Kumar
K
K
Department of Surgery, University of Saskatchewan, Regina, Canada.
Nath
R K
RK
Toth
C
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004599:Electric Stimulation Therapy / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011183:Postoperative Complications / Q000503:physiopathology / Q000628:therapy; D019736:Prostheses and Implants; D012008:Recurrence; D012019:Reflex Sympathetic Dystrophy / Q000503:physiopathology / Q000628:therapy*; D013116:Spinal Cord / Q000503:physiopathology*; D013562:Sympathectomy; D016896:Treatment Outcome