Spinal cord stimulation in peripheral arterial disease

A cooperative study

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  • 1 Departments of Neurosurgery, Hospital Universitario, Salamanca, Hospital Mora, Cádiz, Hospital Nuestra Señora de la Candelaria, Tenerife, and Hospital Universitario, Valencia, Spain
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✓ Percutaneous epidural Stimulation of the low thoracic spinal cord was carried out in 41 patients with pain from peripheral arterial disease of the lower limbs. Results are reported relating to pain, claudication distance, peripheral blood flow, and trophic lesion changes. Following a trial period of stimulation, 37 patients had stimulators permanently implanted. After a mean poststimulation follow-up period of 25 months, substantial pain relief (75% to 100%) was obtained in 29 cases; claudication distance significantly increased in 15 cases; Doppler ultrasound recordings of lower-limb distal arteries showed a tendency toward normalization of pulse-wave morphology, with increase of amplitude in 12 of the 23 patients studied; a rise in skin temperature was also detected by thermography. Distal arterial blood pressure remained unchanged with stimulation. Ischemic cutaneous trophic lesions of less than 3 sq cm healed, but gangrenous conditions were not benefited. A placebo effect or the natural history of the disease can be excluded as the reason for these improvements. It is concluded that spinal cord stimulation is a valid alternative treatment for moderate peripheral arterial disorders when direct arterial surgery is not possible or has been unsuccessful.

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JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

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  • 1.

    Augustinsson LE: Discussion on spinal cord stimulation and peripheral blood flow, in Hosobuchi Y, & Corbin T (eds): Indications for Spinal Cord Stimulation. Amsterdam: Excerpta Medica, 1981, pp 7275 Augustinsson LE: Discussion on spinal cord stimulation and peripheral blood flow, in Hosobuchi Y, Corbin T (eds): Indications for Spinal Cord Stimulation. Amsterdam: Excerpta Medica, 1981, pp 72–75

    • Search Google Scholar
    • Export Citation
  • 2.

    Augustinsson LE, , Carlsson CA, & Fall M: Autonomic effects of electrostimulation. Appl Neurophysiol 45:185189, 1982 Augustinsson LE, Carlsson CA, Fall M: Autonomic effects of electrostimulation. Appl Neurophysiol 45:185–189, 1982

    • Search Google Scholar
    • Export Citation
  • 3.

    Broseta J, , Roldan P, & Gonzalez-Darder J, et al: Chronic epidural dorsal column stimulation in the treatment of causalgic pain. Appl Neurophysiol 45:190194, 1982 Broseta J, Roldan P, Gonzalez-Darder J, et al: Chronic epidural dorsal column stimulation in the treatment of causalgic pain. Appl Neurophysiol 45:190–194, 1982

    • Search Google Scholar
    • Export Citation
  • 4.

    Cook AW, , Oygar A, & Baggenstos P, et al: Vascular disease of extremities. Electrical stimulation of spinal cord and posterior roots. NY State J Med 76:366368, 1976 Cook AW, Oygar A, Baggenstos P, et al: Vascular disease of extremities. Electrical stimulation of spinal cord and posterior roots. NY State J Med 76:366–368, 1976

    • Search Google Scholar
    • Export Citation
  • 5.

    Dooley DM, & Kasprak M: Modification of blood flow to the extremities by electrical stimulation of the nervous system. South Med J 69:13091311, 1976 Dooley DM, Kasprak M: Modification of blood flow to the extremities by electrical stimulation of the nervous system. South Med J 69:1309–1311, 1976

    • Search Google Scholar
    • Export Citation
  • 6.

    Fiume D: Spinal cord stimulation in peripheral vascular pain. Appl Neurophysiol 46:290294, 1983 Fiume D: Spinal cord stimulation in peripheral vascular pain. Appl Neurophysiol 46:290–294, 1983

    • Search Google Scholar
    • Export Citation
  • 7.

    Foerster O: The dermatomes in man. Brain 56:139, 1933 Foerster O: The dermatomes in man. Brain 56:1–39, 1933

  • 8.

    Friedman H, , Nashold BS Jr, & Somjen G: Physiological effects of dorsal column stimulation, in Bonica JJ (ed): International Symposium on Pain. Advanced Neurology, Vol 4. New York: Raven Press, 1974, pp 769773 Friedman H, Nashold BS Jr, Somjen G: Physiological effects of dorsal column stimulation, in Bonica JJ (ed): International Symposium on Pain. Advanced Neurology, Vol 4. New York: Raven Press, 1974, pp 769–773

    • Search Google Scholar
    • Export Citation
  • 9.

    Hilton SM, & Marshall JM: Dorsal root vasodilatation in cat skeletal muscle. J Physiol (Lond) 229:277288, 1980 Hilton SM, Marshall JM: Dorsal root vasodilatation in cat skeletal muscle. J Physiol (Lond) 229:277–288, 1980

    • Search Google Scholar
    • Export Citation
  • 10.

    Meglio M, & Cioni B: Personal experience with spinal cord stimulation in chronic pain management. Appl Neurophysiol 45:195200, 1982 Meglio M, Cioni B: Personal experience with spinal cord stimulation in chronic pain management. Appl Neurophysiol 45:195–200, 1982

    • Search Google Scholar
    • Export Citation
  • 11.

    Meglio M, , Cioni B, & Dal Lago A, et al: Pain control and improvement of peripheral blood flow following epidural spinal cord stimulation. Case report. J Neurosurg 54:821823, 1981 Meglio M, Cioni B, Dal Lago A, et al: Pain control and improvement of peripheral blood flow following epidural spinal cord stimulation. Case report. J Neurosurg 54:821–823, 1981

    • Search Google Scholar
    • Export Citation
  • 12.

    Meglio M, , Cioni B, & Sandric S: Evaluation of cardiac activity during spinal cord stimulation, in Hosobuchi Y, & Corbin T (eds): Indications for Spinal Cord Stimulation. Amsterdam: Excerpta Medica, 1981, pp 6775 Meglio M, Cioni B, Sandric S: Evaluation of cardiac activity during spinal cord stimulation, in Hosobuchi Y, Corbin T (eds): Indications for Spinal Cord Stimulation. Amsterdam: Excerpta Medica, 1981, pp 67–75

    • Search Google Scholar
    • Export Citation
  • 13.

    Meglio M, , Cioni B, & Sandric S: Spinal cord stimulation and peripheral blood flow, in Hosobuchi Y, & Corbin T (eds): Indications for Spinal Cord Stimulation. Amsterdam: Excerpta Medica, 1981, pp 6066 Meglio M, Cioni B, Sandric S: Spinal cord stimulation and peripheral blood flow, in Hosobuchi Y, Corbin T (eds): Indications for Spinal Cord Stimulation. Amsterdam: Excerpta Medica, 1981, pp 60–66

    • Search Google Scholar
    • Export Citation
  • 14.

    Rose SS: The use and abuse of vasodilator drugs. Vasc Dis 4:6782, 1971 Rose SS: The use and abuse of vasodilator drugs. Vasc Dis 4:67–82, 1971

    • Search Google Scholar
    • Export Citation
  • 15.

    Saria A, , Lundberg JM, & Brodin E, et al: Substance P and vascular protein leakage in various tissues of rat and guinea pig, in Skrabanek P, & Powell D (eds): Substance P. Dublin: Boole Press, 1983, pp 9495 Saria A, Lundberg JM, Brodin E, et al: Substance P and vascular protein leakage in various tissues of rat and guinea pig, in Skrabanek P, Powell D (eds): Substance P. Dublin: Boole Press, 1983, pp 94–95

    • Search Google Scholar
    • Export Citation
  • 16.

    Szczeklik A, , Nizankowski R, & Skawinski S, et al: Successful therapy of advanced arteriosclerosis obliterans with prostacyclin. Lancet 1:11111114, 1979 Szczeklik A, Nizankowski R, Skawinski S, et al: Successful therapy of advanced arteriosclerosis obliterans with prostacyclin. Lancet 1:1111–1114, 1979

    • Search Google Scholar
    • Export Citation
  • 17.

    Tallis RC, , Illis LS, & Sedgwick EM, et al: Spinal cord stimulation in peripheral vascular disease. J Neurol Neurosurg Psychiatry 46:478484, 1983 Tallis RC, Illis LS, Sedgwick EM, et al: Spinal cord stimulation in peripheral vascular disease. J Neurol Neurosurg Psychiatry 46:478–484, 1983

    • Search Google Scholar
    • Export Citation

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