JOURNAL ARTICLE

Spinal cord stimulation for chronic visceral abdominal pain

Leonardo Kapural, Hassan Nagem, Heather Tlucek, Daniel I Sessler
Pain Medicine 2010, 11 (3): 347-55
20088856

BACKGROUND: Spinal cord stimulation (SCS) may reduce pain scores and improve function in patients with chronic visceral abdominal pain. We thus present our large clinical experience in SCS for visceral abdominal pain.

METHODS: We trialed spinal cord stimulation in 35 patients, each of whom was shown by retrograde differential epidural block to have either visceral pain (n = 32) or mixed visceral and central pain (n = 3). SCS trials lasted 4 to 14 days (median 9 days). SCS lead tips were mostly positioned at T5 (n = 11) or T6 (n = 10).

RESULTS: Thirty patients (86%) reported at least 50% pain relief upon completion of the trial. Among these, pretrial visual analog scale (VAS) pain scores averaged 8.2 +/- 1.6 (SD) and opioid use averaged 110 +/- 119 mg morphine sulfate equivalents. During the trial, VAS pain scores decreased to 3.1 +/- 1.6 cm (P < 0.001, Mann-Whitney Rank Sum Test) and opioid use decreased to 70 +/- 68 mg morphine equivalent a day (P = 0.212). Five patients failed the trial, one was lost to follow-up, and 19 were followed for the whole year. Seven patients were either followed for less than a year (n = 3) or the SCS system was removed due to infection or lead migration (n = 4). One patient despite the successful trial felt no improvements at 6 months after the implant and requested an explant of the SCS device. Among the 28 patients who received permanent implant, 19 were followed at least a year. Their VAS pain scores remained low (3.8 +/- 1.9 cm; P < 0.001) at 1 year, as did opioid use (38 +/- 48 mg morphine equivalents; P = 0.089).

CONCLUSIONS: Spinal cord stimulation may be a useful therapeutic option for patients with severe visceral pain.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
20088856
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"

We want to hear from doctors like you!

Take a second to answer a survey question.