Electrical spinal cord stimulation in reflex sympathetic dystrophy: retrospective analysis of 23 patients

Object. The aim of the study was to assess retrospectively the clinical eff icacy and possible adverse effects of electrical spinal cord stimulation (S CS) for the treatment of patients with reflex sympathetic dystrophy (RSD). Methods. Twenty-three patients who suffered severe pain due to RSD were inc luded in the study. The SCS system was implanted only after a positive 1-we ek test period. The visual analog scale (VAS) score for pain (1-10) was obt ained in all patients prior to treatment, 1 month postimplantation, and at last follow up. At final follow-up examination, patients were asked to rate the effect of their treatment on the 7-point global perceived effect scale . Eighteen (78%) of 23 patients treated between 1991 and 1997 reported impr ovement during the test period. Permanent implantation of SCS system was no t performed in the other five patients. Complications occurred in nine (50% ) of 18 patients. The system was removed in three patients after implantati on (17%). At the end of follow up (mean 32 months) 15 patients still had an implanted system. The mean pain score had decreased from 7.9 to 5.4 (p < 0 .001). In the other eight patients the pain score had not changed significa ntly. In 13 patients (57%) in whom the SCS system was implanted, clinical s tatus had much improved or improved; these cases were regarded as successfu l. Conclusions. In this retrospective series, the majority of patients with RS D reported a subjective improvement after implantation of an SCS system.