Spinal kord stimulasyonunun Retrospektif Analizi: 15 Yıllık Tek Merkez Deneyimi

Öz

Spinal kord stimülasyonu (SKS), kronik ağrı yönetimi için belirlenmiş bir nöromodülasyon tekniğidir. Bu çalışma, çeşitli kronik ağrı durumlarında SKS tedavisinin sonuçlarını ve komplikasyonlarını değerlendirmektedir. Bu retrospektif, tek merkezli kohort çalışmasında, Ocak 2008 ile Aralık 2023 arasında SKS implantasyonu uygulanan 61 hasta analiz edildi. Başarılı tedavi, Sayısal Derecelendirme Ölçeği (SDÖ) puanlarında >%50 azalma olarak tanımlandı. Hasta memnuniyeti 5 puanlı Likert ölçeği kullanılarak değerlendirildi. İkincil sonuçlar arasında komplikasyonlar, revizyon gereksinimleri ve cihazın uzun ömürlülüğü yer aldı. Başarısız Sırt Cerrahisi Sendromu (BBCS) en yaygın endikasyondu (%73,8), bunu periferik vasküler hastalık (PVH) (%8,2) izledi. Genel tedavi etkinliği hastaların %90,2'sinde elde edildi ve kompleks bölgesel ağrı sendromu (KBAS), PVH, fantom ağrısı, periferik sinir hasarı, spinal tümör ve felçle ilişkili nöropatik ağrı için %100 başarı oranları elde edildi. BBCS hastaları arasında %86,7'si önemli ağrı azalması elde etti. Hasta memnuniyeti yüksekti, %82.0'ı olumlu memnuniyet bildirdi (%67.2 çok memnun, %14.8 kısmen memnun). Vakaların %16.4'ünde SKS revizyonu gerekti, %8.2'sinde tedavi sonlandırıldı ve %18.0'inde implante edilebilir puls jeneratörü değişimi gerekti. Tedavi başarısızlık oranı sadece %3.3'tü. SKS, çeşitli kronik ağrı durumlarında yüksek tedavi etkinliği ve hasta memnuniyeti gösterdi. Düşük tedavi başarısızlık oranlarına sahip olumlu güvenlik profili, uygun hasta seçimi kriterleriyle uygulandığında SKS'yi kapsamlı ağrı yönetimi stratejilerinin önemli bir bileşeni olarak desteklemektedir.

Anahtar Kelimeler

• Spinal kord stimulasyonu
• Kronik ağrı tedavisi
• Nöromodülasyon

Retrospective Analysis of Spinal Cord Stimulation: 15-Year Single-Center Experience

Öz

Spinal cord stimulation (SCS) is an established neuromodulation technique for chronic pain management. This study evaluated outcomes and complications of SCS therapy across various chronic pain conditions. This retrospective, single-center cohort study analyzed 61 patients who received SCS implantation between January 2008 and December 2023. Treatment effectiveness was defined as a >50% reduction in Numeric Rating Scale (NRS) scores. Patient satisfaction was assessed using a 5-point Likert scale. Secondary outcomes included complications, revision requirements, and device longevity. Failed Back Surgery Syndrome (FBSS) was the most common indication (73.8%), followed by peripheral vascular disease (PVD) (8.2%). Overall treatment effectiveness was achieved in 90.2% of patients, with 100% success rates for complex regional pain syndrome (CRPS), PVD, phantom pain, peripheral nerve damage, spinal tumor, and stroke-related neuropathic pain. Among FBSS patients, 86.7% achieved significant pain reduction. Patient satisfaction was high, with 82.0% reporting positive satisfaction (67.2% very satisfied, 14.8% partially satisfied). Revision surgery was required in 16.4% of cases, treatment termination occurred in 8.2%, and implantable pulse generator replacement was necessary in 18.0%. Treatment failure rate was only 3.3%. SCS demonstrated high treatment effectiveness and patient satisfaction across various chronic pain conditions. The favorable safety profile with low treatment failure rates supports SCS as an important component of comprehensive pain management strategies when applied with appropriate patient selection criteria.

Anahtar Kelimeler

• Spinal cord stimulation
• Chronic pain management
• Neuromodulation

Kaynakça

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