Spinal cord stimulation for the treatment of complex regional pain syndrome: A systematic review of randomized controlled trials

Ryan Mattie , Alan Bingtao Lin , Harjot Bhandal , Benjamin Gill , Jennifer Tram , Samamtha Braun , Nitin Prabakar , Claire Tian Yin , Nick Brar , Andrew Fox , Mikhail Saltychev
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Abstract

Background

Spinal Cord Stimulation (SCS) is a widely recognized treatment for Complex Regional Pain Syndrome (CRPS), particularly in cases where traditional methods are ineffective. This paper systematically reviews randomized controlled trials to analyze the efficacy of SCS, as well as Dorsal Root Ganglion (DRG) Stimulation in treating CRPS, focusing on its long-term effectiveness.

Methods

This systematic review focused exclusively on randomized controlled trials to assess a primary outcome of improvement in pain symptoms in patients diagnosed with CRPS. The primary outcomes assessed were pain reduction and patient satisfaction, with attention to functional improvement, quality of life improvement, preference for waveform settings, and complications when such data was made available.

Results

The results showed significant pain reduction in CRPS patients treated with SCS and DRG. Preference for specific SCS settings varied among patients, with no clear superiority of one setting over another. Innovations in SCS technology, including novel waveforms and frequencies, demonstrated potential for enhanced efficacy and patient comfort.

Conclusions

The review underscores the importance of SCS and DRG as significant treatment options to reduce pain for patients suffering from CRPS. It highlights the need for ongoing research to optimize SCS therapy, focusing on individual patient preferences and responses to different stimulation parameters. This personalized approach could lead to improved patient outcomes in CRPS management. Additionally, as this study only contained data from Randomized Controlled Trials, inclusion of well-conducted observational studies may help to provide stronger evidence for use of this therapy in CRPS patients.

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脊髓刺激治疗复杂局部疼痛综合征:随机对照试验的系统回顾。
背景:脊髓刺激(SCS)是一种被广泛认可的治疗复杂局部疼痛综合征(CRPS)的方法,特别是在传统方法无效的情况下。本文系统回顾随机对照试验,分析SCS和刺激背根神经节(Dorsal Root Ganglion, DRG)治疗CRPS的疗效,重点关注其远期疗效。方法:本系统综述专门关注随机对照试验,以评估诊断为CRPS的患者疼痛症状改善的主要结局。评估的主要结果是疼痛减轻和患者满意度,并关注功能改善、生活质量改善、对波形设置的偏好以及这些数据可用时的并发症。结果:经SCS和DRG治疗的CRPS患者疼痛明显减轻。不同患者对特定SCS设置的偏好不同,没有一种设置明显优于另一种设置。SCS技术的创新,包括新的波形和频率,显示了增强疗效和患者舒适度的潜力。结论:该综述强调了SCS和DRG作为减轻CRPS患者疼痛的重要治疗选择的重要性。它强调了优化SCS治疗的持续研究的必要性,重点是个体患者的偏好和对不同刺激参数的反应。这种个性化的方法可以改善CRPS管理的患者结果。此外,由于本研究仅包含随机对照试验的数据,因此纳入进行良好的观察性研究可能有助于为CRPS患者使用该疗法提供更有力的证据。
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