title: Quantitative sensory testing in patients with chronic unilateral radicular neuropathic pain and active spinal cord stimulation.
abstract: Objectives.  Spinal cord stimulation (SCS) is an effective treatment option for chronic radicular neuropathic pain syndromes. This prospective study was performed to examine the peripheral effects of SCS on sensation using quantitative sensory testing (QST). Materials and Methods.  We measured two consecutive QST measurements for thermal, tactile-static, tactile-dynamic, vibratory, and pain sensation of the lower limbs in seven patients with chronic unilateral radicular neuropathic pain who underwent SCS implantation for their pain. Measurements were performed when SCS was turned off and once again during SCS and subsequent reduced pain levels. Results.  Baseline QST demonstrated significantly increased thresholds for tactile and warm and cold detection in the pain area. With SCS active, a significant reduction of the cold and warm perception and mechanical detection thresholds was found on the painful side (p < 0.01). Although not significant (p > 0.01), altered sensory thresholds with active SCS also were found at the healthy side where no paresthesias were felt. Conclusion.  SCS leads to bilateral subclinical effects even if the evoked paresthesias are only unilateral. Pain perception thresholds are not altered with therapeutic SCS.
authors.affiliation: Department of Neurosurgery, University Hospital of Heidelberg, Heidelberg;              Department of Neurology, Division of Neuroradiology, University Hospital of Heidelberg, Heidelberg;              Department of Neurosurgery, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Rasche
authors.forename: Marc A
authors.initials: MA
authors.lastname: Ruppolt
authors.forename: Bodo
authors.initials: B
authors.lastname: Kress
authors.forename: Andreas
authors.initials: A
authors.lastname: Unterberg
authors.forename: Volker M
authors.initials: VM
authors.lastname: Tronnier