St Chiara University Hospital PISA ITALY The Pain

St. Chiara University Hospital PISA – ITALY

The Pain Medicine Department Multidisciplinary Staff UNIT HEAD : • Prof. Paolo Poli - anesthesiologist • Dott. ssa Lara Tollapi- anesthesiologist • Dott. ssa Franca Bondi - reumatologist • Dott. Walter Forli - neurosurgery • Dott. ssa Mery Paroli - psychologist • Dott. ssa Antonella Ciaramella - psychiatric NURSE STAFF: • Antonella Scocca - Nurse coordinator • Sabrina Inghirami - CS Nurse • Tatiana De Lucia - CS Nurse • Paola Lencioni - CS Nurse • Maida Natucci - Nurse Support • Maria Sadowska - Nurse Support • Maria Coppola - Secretary • Giuliana Rossano - Counselor

Background 1 of 2 Spinal cord stimulation (SCS) is an efficacious therapy for chronic neuropathic pain even though pharmacological relief is insufficient. Atkinson et al. , 2011; Kemler et al. , 2000; Kumar et al. , 2007; North et al. , 2005; Simpson et al. , 2009; Peng et al. , 2007; Van Buyten et al. , 2006

Background 2 of 2 Three brands of SCS stimulators … Constant current with single power source Constant current with multiple power sources Constant voltage with a single power source Different brands of SCS for. . . different technologies

Aim of the study Compare the effectiveness in pain relief of three different types of stimulation in patients with diagnosis of chronic neuropathic pain during two years follow-up after the implant of SCS.

Multidisciplinary Screening Anaesthesiologic Internal Medicine Psychiatric Psychological

Sample 1/2 • FBSS: Failed Back Surgery Syndrome • LB: Low Back • Miscellanea: • Phantom Pain MISCELLANEA 39 • Ischemic Pain • Post Herpetic Pain • Complex Pain Regional Syndrome • Arthritis • Genital Anal Pain 168 patients with neuropathic pain

Sample 2/2 Observational study

Study design 1/2 VAS 3 dimensions of pain: • Sensory • Affective • Evaluative 0 No pain 10 Worst possible pain

Study design 2/2 IPQ VAS 0 Before implant T 0 10 3 mths 6 mths 12 mths 18 mths 24 mths T 1 T 2 T 3 T 4 T 5

Results 1/2 Repeated Measures ANOVA - VAS F = 57. 87 p <. 0001

24 mths 18 mths 12 mths Ev T 0 alu ati 3 mths ve 6 mths 24 mths 18 mths Aff 3 mths ect ive 6 mths 12 mths T 0 24 mths Se 6 mths ns ori 12 mths al 18 mths 3 mths T 0 Results 2/2 Repeated Measures ANOVA - IPQ dimensions 0. 6 0. 5 0. 4 0. 3 Medtronic 0. 2 St. Jude 0. 1 BSC 0 p = n. s.

Conclusions The present study proved SCS in itself to be effective in the treatment of chronic neuropathic pain, although no significant differences were shown among the three systems.

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