title: Epidural spinal cord stimulation for neuropathic pain: a neurosurgical multicentric Italian data collection and analysis.
abstract: BACKGROUND
  Spinal cord stimulation (SCS) is a technique used worldwide to treat several types of chronic neuropathic pain refractory to any conservative treatment. The aim of this data collection is to enforce evidence of SCS effectiveness on neuropathic chronic pain reported in the literature and to speculate on the usefulness of the trial period in determining the long-term efficacy. Moreover, the very low percentage of undesired side effects and complications reported in our case series suggests that all implants should be performed by similarly well-trained and experienced professionals.
  
  
  METHODS
  A multicentric data collection on a common database from 11 Italian neurosurgical departments started 3 years ago. Two different types of electrodes (paddle or percutaneous leads) were used. Of 122 patients, 73 % (N = 89) were submitted to a trial period, while the remaining patients underwent the immediate permanent implant (N = 33). Statistical comparisons of continuous variables between groups were performed.
  
  
  RESULTS
  Most of the patients (80 %) had predominant pain to their lower limbs, while only 17 % of patients had prevalent axial pain. Significant reduction in pain, as measured by variation in visual analogue scale (VAS) score, was observed at least 1 year after implantation in 63.8 % of the cases, 59.5 % of patients who underwent a test trial and 71.4 % of patients who underwent permanent implant at once. No statistical differences were found between the lower-limb pain group and the axial pain group.
  
  
  CONCLUSIONS
  No relevant differences in long-term outcomes were observed in previously tested patients compared with patients implanted at once. Through this analysis we hope to recruit new centres, to give more scientific value to our results.
authors: Department of Neurosurgery, IRCCS San Raffaele Hospital, Via Olgettina 60 Segrate, Milan, Italy, colombo.elenavirginia@hsr.it.
authors: Elena Virginia
authors: EV
authors: Colombo
authors: Carlo
authors: C
authors: Mandelli
authors: Pietro
authors: P
authors: Mortini
authors: Giuseppe
authors: G
authors: Messina
authors: Nicola
authors: N
authors: De Marco
authors: Roberto
authors: R
authors: Donati
authors: Claudio
authors: C
authors: Irace
authors: Andrea
authors: A
authors: Landi
authors: Angelo
authors: A
authors: Lavano
authors: Massimo
authors: M
authors: Mearini
authors: Stefano
authors: S
authors: Podetta
authors: Domenico
authors: D
authors: Servello
authors: Edvin
authors: E
authors: Zekaj
authors: Carlo
authors: C
authors: Valtulina
authors: Ivano
authors: I
authors: Dones
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection; D004824:Epidural Space / Q000502:physiology* / Q000601:surgery; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000601:surgery / Q000628:therapy*; D062187:Spinal Cord Stimulation / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D016896:Treatment Outcome