Korean J Pain.  2019 Jan;32(1):47-50. 10.3344/kjp.2019.32.1.47.

Successful removal of permanent spinal cord stimulators in patients with complex regional pain syndrome after complete relief of pain

• Lee SJ
• Yoo YM
• You JA
• Shin SW
• Kim TK
• Abdi S
• Kim KH

• KMID: 2430763
• DOI: http://doi.org/10.3344/kjp.2019.32.1.47

Abstract

BACKGROUND
It is uncommon for patients who have received a permanent implant to remove the spinal cord stimulator (SCS) after discontinuation of medication in complex regional pain syndrome (CRPS) due to their completely painless state. This study evaluated CRPS patients who successfully removed their SCSs.
METHODS
This 10-year retrospective study was performed on patients who had received the permanent implantation of an SCS and had removed it 6 months after discontinuation of stimulation, while halting all medications for neuropathic pain. Age, sex, duration of implantation, site and type of CRPS, and their return to work were compared between the removal and non-removal groups.
RESULTS
Five (12.5%, M/F = 4/1) of 40 patients (M/F = 33/7) successfully removed the permanent implant. The mean age was younger in the removal group (27.2 ± 6.4 vs. 43.5 ± 10.7 years, P < 0.01). The mean duration of implantation in the removal group was 34.4 ± 18.2 months. Two of 15 patients (13.3%) and 3 of 25 patients (12%) who had upper and lower extremity pain, respectively, had removed the implant. The implants could be removed in 5 of 27 patients (18.5%) with CRPS type 1 (P < 0.01). All 5 patients (100%) who removed their SCS returned to work, while only 5 of 35 (14.3%) in the non-removal group did (P < 0.01).
CONCLUSIONS
Even though this study had limited data, younger patients with CRPS type 1 could remove their SCSs within a 5-year period and return to work with complete pain relief.

Keyword

Age factors; Complex regional pain syndrome; Device removal; Extremities; Humans; Neuropathic pain; Retrospective studies; Return to work; Spinal cord stimulation

MeSH Terms

Age Factors
Device Removal
Extremities
Humans
Lower Extremity
Neuralgia
Retrospective Studies
Return to Work
Spinal Cord Stimulation
Spinal Cord*

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