Spinal cord stimulation for complex regional pain syndrome
Clinical bottom line
There is limited evidence of long-term benefit from a single randomised trials and a number of case series.
Reference
RS Taylor et al. Spinal cord stimulation for complex regional pain syndrome: a systematic review of the clinical and cost-effectiveness literature and assessment of prognostic factors. European Journal of Pain 2006 10: 91-101.
Systematic review
- Date review completed: Searching was completed in January 2002.
- Number of trials included: 1 RCT (open), 25 case series, 1 economic evaluation
- Number of patients: 54 in RCT, 500 in case series
- Control group: Physical therapy alone in the RCT
- Main outcomes: Various
Results
The randomised trial showed some benefit, with a reduction in pain of 2.4 units (presumably out of 10 on a VAS scale) at six months and 2.7 at 12 months.
The 25 case series were judged to be of generally poor quality, and were small. On average 67% achieved at least 50% pain reduction.
Cost effectiveness was calculated on the basis of the RCT, with a cost per quality-adjusted life year of Euro22,600.
Comment
Little in the way of evidence here, but such as it is implies that spinal cord stimulation can be beneficial in a difficult medical condition.