İskemik Ağrıda Spinal Kord Stimülasyonu: Olgu Serisi

Öz

ÖZ Amaç Kronik ağrı tedavisinde, girişimsel yöntemler içinde nöromodülasyon teknikleri önemli bir yer tutmaktadır. Spinal Kord Stimülasyonu (SKS), nöromodülasyon teknikleri arasında en sık uygulanan tedavi yöntemidir. SKS işlemi, İskemik ağrı, yetersiz bel cerrahisi, nöropatik ağrı ve kanser ağrısında kullanılabilen bir nöromodulasyon yöntemidir. Çalışmamızda, periferik damar hastalığına (PDH bağlı, alt ekstremitede iskemik kronik ağrı tanısı olan hastalarla, SKS’nin ağrı şiddetine etkileri araştırıldı. Gereç ve Yöntemler SKS yerleştirilmiş olan 10 hastanın Nisan 2020-Nisan 2024 arasındaki medikal kayıtları incelendi.. Hastaların ikisinde (%20) kronik anjina pektorise bağlı göğüs ağrısı, sekizin de de (%80) PVH nedeniyle alt ekstremite ağrısı vardı. SKS işlemi öncesi ve sonrası görsel analog skala derecelerine (VAS) göre ağrı skorlarını, opioid kullanımı ve hastaların işlem memnuniyetini karşılaştırdık. Bulgular Olguların işlem öncesi ve sonrası ağrı skorları değerlendirildi. Tüm olguların SKS işlemi öncesi VAS 9.00 ± 0.81, işlemden sonra birinci ayda kaydedilen VAS 2.90 ± 0.99 olarak bulunmuştur. SKS sonrası hastaların tümünün ağrı şiddetinin belirgin olarak azaldığı görülmüştür. Bu azalma istatistiksel olarak anlamlı bulunmuştur (p<0.05). Sonuç Çalışmamızın sonuçlarına göre SKS’nin etkili ve güvenilir bir tedavi yöntemi olduğu görüşündeyiz. Tüm medikal ve cerrahi yöntemlerinin yetersiz kaldığı anjina pektoris ve PVH gibi şiddetli iskemik ağrıya sebep olan durumlarda, SKS işlemi bir tedavi seçeneği olarak düşünülmelidir. SKS, kronik ciddi iskemik ağrıda etkili ve başarılı bir tedavi yöntemidir.

Anahtar Kelimeler

• Kronik ağrı
• Spinal kord stimülasyonu
• İskemik ağrı

Spinal Cord Stimulation in Ischemic Pain: A Case Series

Abstract

ABSTRACT Objective Neuromodulation has a significant place among the interventional methods, in the treatment of chronic pain. Spinal Cord Stimulation (SCS) is the most applied treatment method among neuromodulation methods. SCS procedure is a neuromodulation method used for ischemic pain, failed back surgery syndrome, neuropathic pain, and cancer pain. In our study, the effects of SCS on pain intensity were investigated in patients diagnosed with ischemic chronic pain in the lower extremity due to peripheral vascular disease (PVD). Material and Methods The ten patients who were applied SCS were included in the retrospective study conducted between April 2020-April 2024 in the University Algology Department. Two (20%) of the patients had chest pain due to chronic angina pectoris, and 8 (80%) had lower extremity pain due to PVH. We compared pain scores in line with visual analog scale degrees (VAS) before and after the SCS procedure, opioid use and compared the patient satisfaction with the procedure. Results Pain scores of the patients before and after the procedure were evaluated. The VAS of all cases before the SCS procedure was 9.00 ± 0.81, and the VAS recorded in the 1st month after the procedure was 2.90 ± 0.99. It was observed that the pain intensity of all patients decreased significantly after SCS. This decrease was found to be statistically significant (p<0.05). Conclusion According to the results of our study, we are of the opinion that SCS is an effective and safe treatment method. In cases where all medical and surgical methods are insufficient and cause severe ischemic pain, such as angina pectoris and PVH, the SCS procedure should be considered as a treatment option. SCS is an effective and successful treatment method for chronic severe ischemic pain.

Keywords

• Chronic pain
• Spinal cord stimulation
• Ischemic pain

Kaynakça

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