title: Spinal cord stimulation is effective in management of complex regional pain syndrome I: fact or fiction.
abstract: BACKGROUND
  Complex regional pain syndrome (CRPS) I is a debilitating neuropathic pain disorder characterized by burning pain and allodynia. Spinal cord stimulation (SCS) is effective in the treatment of CRPS I in the medium term but its long-term efficacy and ability to improve functional status remains controversial.
  
  
  OBJECTIVE
  To evaluate the ability of SCS to improve pain, functional status, and quality of life in the long term.
  
  
  METHODS
  We retrospectively analyzed 25 patients over a mean follow-up period of 88 months. The parameters for evaluation were visual analog scale (VAS), Oswestry Disability Index (ODI), Beck Depression Inventory (BDI), EuroQoL-5D (EQ-5D) and Short Form 36 (SF-36), and drug consumption. Evaluations were conducted at point of entry, 3 months, 12 months, and last follow-up at 88 months (mean).
  
  
  RESULTS
  At baseline, the mean scores were VAS 8.4, ODI 70%, BDI 28, EQ-5D 0.30, and SF-36 24. In general, maximum improvement was recorded at follow-up at 3 months (VAS 4.8, ODI 45%, BDI 15, EQ-5D 0.57, and SF-36 45). At last follow-up, scores were 5.6, 50%, 19, 0.57, and 40, respectively. Despite some regression, at last follow-up benefits were maintained and found to be statistically significant (P < .001) compared with baseline. Medication usage declined. SCS did not prevent disease spread to other limbs. Best results were achieved in stage I CRPS I, patients under 40 years of age, and those receiving SCS within 1 year of disease onset.
  
  
  CONCLUSIONS
  SCS improves pain, quality of life, and functional status over the long term and consequently merits early consideration in the treatment continuum.
authors: Section of Neurosurgery, Department of Surgery, Regina General Hospital, University of Saskatchewan, Regina, Saskatchewan, Canada. krishna.kumar@rqhealth.ca
authors: Krishna
authors: K
authors: Kumar
authors: Syed
authors: S
authors: Rizvi
authors: Sharon Bishop
authors: SB
authors: Bnurs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D003863:Depression / Q000209:etiology; D004185:Disability Evaluation; D018450:Disease Progression; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010146:Pain / Q000209:etiology; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011569:Psychiatric Status Rating Scales; D012019:Reflex Sympathetic Dystrophy / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D013116:Spinal Cord / Q000503:physiopathology*; D016896:Treatment Outcome
chemical_list: D000700:Analgesics