Purpose of the work. The article is devoted to the first experience of epidural stimulation in the Khanty-Mansiysk Autonomous Okrug at the budgetary institution Surgut Clinical Trauma Hospital. Clinical examples are presented for two main indications for the application of this technique (disease of the operated spine, a consequence of spinal cord injury in combination with chronic neuropathic pain syndrome).
Research methods. An assessment of the intensity of pain syndrome was given according to a visual analogue scale, the Pain Detect questionnaire; indicators of anxiety, depression on the HADS scale; quality of life according to the Oswestry questionnaire for a follow-up period of 6-12 months in patients with chronic epidural stimulation.
Results. A positive assessment of the action during test neurostimulation was 63.3% (38 patients). Of the established permanent systems, a good result was achieved and persisted for 12 months or more in 96% (24 patients). It was necessary to change the stimulation parameters in 13% (3 patients). Revision of permanent systems was performed in 20% (5 patients), due to the progression of the degenerative-dystrophic process of the spine, damage and migration of system elements.
Conclusions. Chronic epidural spinal cord stimulation has established itself as a personalized, highly effective, minimally invasive and safe method of treating chronic neuropathic pain syndromes. Multicomponent corrective action is of scientific interest and requires further study.
Burst and Tonic Spinal Cord Stimulation Both Activate Spinal GABAergic Mechanisms to Attenuate Pain in a Rat Model of Chronic Neuropathic Pain
