除痛を目的とした硬膜外脊髄刺激法の長期使用成績 Long-term Effect of Epidural Spinal Cord Stimulation

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Abstract

<b>目的</b>: 硬膜外脊髄刺激法 (SCS) 施行後, 3カ月以上経過観察している患者の除痛効果と合併症を検討した. <b>方法</b>: 22人 (男性14人, 女性8人) の慢性難治性疼痛患者にSCSを施行し, 使用前後の visual analogue scale で50%以上の除痛が得られたものを有効とし, それ未満を無効とした. <b>結果</b>: SCSが3カ月~6年6カ月間継続して有効であったのは, 22人中12人で, 残りの10人は途中で無効になった. 無効の10人中6人は, 電極の断線またはずれ, 受信器の故障が原因によるもので, 修正手術によって有効となった. 結局, 22人中18人で有効, 4人で無効であった. 合併症として, 受信器植え込み部位の異物感, 痛み, 潰瘍形成を認めた. <b>結論</b>: SCSで慢性疼痛患者22人中18人を, 重大な合併症なしに長期間効果的に除痛することができた.

Epidural spinal cord stimulation (SCS) was performed for pain control in twenty two patients, 14 males and 8 females with chronic intractable pain. These patients were followed for a period ranging from 3 months to 6.5 years postoperatively. At the time of their monthly visit, magnitudes of pain before and after stimulation were evaluated by using a visual analogue scale (VAS). As demonstrated by VAS, pain continued to decrease by more than 50 % in 12 of 22 SCS patients. In the 10 remainig patients the VAS indicated that pain decreased by 50% or less. In 6 of these 10 patients VAS decreased again by more than 50% after the positions of electrodes were re-adjusted, or replaced with new receiver or connective lead. However, in 4 of 10 patients SCS became ineffective. We demonstrated that SCS was reliable and safe for long-term use in the treatment of patients with chronic intractable pain without serious complications.

Journal

  • Journal of Japan Society of Pain Clinicians

    Journal of Japan Society of Pain Clinicians 3(4), 400-403, 1996

    Japan Society of Pain Clinicians

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