Title.
Aarón Jover Vidal*, Nicolás Cordero Tous*, Isabel María Ortiz García*, Daniel López Campos**, Coralie Maire**, Rafael Gálvez**, Carlos Sánchez Corral*
* Neurosurgery Department. HUVN. Granada (Spain).
** Pain Unit (Anaesthesia Department). HUVN. Granada (Spain).
Background and aims
Complex regional pain syndrome (CRPS) is a clinical entity that produces continuous and disproportionate pain, usually affecting one limb and limiting its functionality. Medical treatment often fails in advanced stages of CRPS. In these cases, spinal cord stimulation (SCS) appears as a useful therapeutic option. The main objective of this study was to assess the analgesic and functional effectiveness and tolerability of SCS in CRPS, as proposed by a transdisciplinary analgesic team of neurosurgeons and anaesthesiologists.
Material and methods
A retrospective analysis of a case series of CRPS treated with SCS, either by percutaneous electrodes or surgically implanted, was performed. After a trial phase (2-4 weeks), patients who reported a reduction in perceived pain intensity of 50% or more were subject to definitive implantation of the generator. The variables evaluated were analgesia, functionality assessed by the Brief Pain Inventory (BPI), analgesic usage and tolerability of SCS.
Results
Out of the 25 patients, 22 received the definitive implant. A mean reduction in pain intensity of 48% (95% CI) was observed. Improvements in physical functioning were also observed as changed from 8.5 to 6.33. Mood also changed from 7.94 to 5.72 I BPI. Eighty percent of patients were satisfied. In only 5 patients, the effectiveness of the system was affected by the presence of painful paraesthesia, progressive loss of effect and discomfort related to the implant, requiring its removal.
Conclusions.
The analgesic effectiveness and functional improvement achieved with SCS support its use in cases of CRPS with chronic refractory pain.

ANALGESIC THERAPY OF COMPLEX REGIONAL PAIN SYNDROME THROUGH SPINAL CORD STIMULATION: A NEW STEP FORWARD