[Spinal cord stimulation - evidence and personal experience].
Spinal cord stimulation (SCS) has been successfully used to treat chronic pain syndromes for decades. For this purpose, an electrode is implanted into the epidural space under local anaesthesia and connected to a neurostimulator which applies a weak direct current to the dorsal roots of the spinal column. Besides pain control, SCS increases the blood supply in the stimulated area. This effect is mediated by a sympathicolytic effect and the liberation of vasodilatators within the stimulated skin area. A Cochrane meta-analysis has revealed a significantly increased limb salvage rate in patients with non-reconstructable critical limb ischaemia (CLI) treated with SCS. The effect of SCS in CLI might be predicted by the measurement of forefoot transcutaneous pO (2) in supine and dependent positions, which renders trial stimulation unnecessary in many cases.
Klein-Weigel
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DRK Kliniken Berlin, Klinik für Innere Medizin - Schwerpunkt Angiologie und kardiovaskuläre Frührehabilitation, Berlin, Deutschland. p.klein-weigel@web.de
D000818:Animals; D001157:Arterial Occlusive Diseases / Q000503:physiopathology* / Q000628:therapy*; D004567:Electrodes, Implanted; D004824:Epidural Space; D019317:Evidence-Based Medicine; D005528:Foot / Q000098:blood supply; D006801:Humans; D058542:Implantable Neurostimulators; D007511:Ischemia / Q000503:physiopathology / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D010100:Oxygen / Q000097:blood; D011379:Prognosis; D013116:Spinal Cord / Q000503:physiopathology*; D013126:Spinal Nerve Roots / Q000503:physiopathology*; D013564:Sympathetic Nervous System / Q000503:physiopathology; D014664:Vasodilation / Q000502:physiology
D010100:Oxygen