Efficacy of spinal cord stimulation in type I complex regional pain syndrome. Literature review.

Abstract

ABSTRACT Introduction: Complex regional pain syndrome (CRPS I and CRPS II), also known as reflex sympathetic dystrophy and causalgia, is a disease characterized by the presence of severe pain, swelling and other changes that occur after an adverse trigger event. Spinal cord stimulation (SCS) is applied by the percutaneous placement of electrodes in the epidural space under fluoroscopy to produce electrical stimulation directly on the posterior spinal cords in order to inhibit the conduction of nociceptive stimuli. Object: The aims of this study were focused on identifying the variables analysed in studies of patients with type I complex regional pain syndrome (CRPS I) treated with SCS and determining the effectiveness of the SCS in type I complex regional pain syndrome. Material and Methods: To meet the objectives proposed in the present study, a literature review was conducted in the following databases: MEDLINE, PEDro, LILACS, IBECS, SPORTDiscus, Academic search complete and CINAHL. In addition, publishing platforms such as ScienceDirect, SpringerLink, OVID, ProQuest and Elsevier were consulted. The most recent search among all documentary resources was conducted in June 2016. The studies to be included were those analysing the effects of SCS on CRPS I. Results and conclusions: From 213 articles identified, 22 studies were selected to be part of this review (11 clinical trials and 11 case reports). The variables studied were pain, quality of life, functional status, trophic and vasomotor disturbances, temperature, patient satisfaction and treatment costs. The studies revealed a significant decrease in pain, which greatly enhanced the quality of life of patients with CRPS I in the short term. SCS also influenced the temperature and improved the trophic changes of the affected limb, although the effect on vasomotor disturbances and functional status is unclear.