st. chiara university hospital pisa – italy

St. Chiara University HospitalPISA – ITALY

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

The Pain Medicine Department Multidisciplinary Staff

Background 1 of 2

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

Spinal cord stimulation (SCS) is an efficacious therapy for chronic neuropathic pain even though pharmacological relief is insufficient.

Background 2 of 2 Three brands of SCS stimulators …

Constant current with multiple power sources

Constant current with single power source

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 Internal

Medicine

Psychological

Psychiatric

Anaesthesiologic

Sample 1/2

168 patients with neuropathic pain

• FBSS: Failed Back Surgery Syndrome

• LB: Low Back• Miscellanea:

• Phantom Pain• Ischemic Pain• Post Herpetic Pain• Complex Pain Regional

Syndrome• Arthritis• Genital Anal Pain

MISCELLANEA39

Sample 2/2

Observational study

Study design 1/2

3 dimensions of pain:• Sensory• Affective• Evaluative

VAS

0No

pain

10Worst

possible pain

Study design 2/2

T0 T1 T2 T3 T4 T5

Beforeimplant

3mths

6mths

12mths

IPQ

VAS

0 10

18mths

24mths

Results 1/2Repeated Measures ANOVA - VAS

F = 57.87p <.0001

T0

3 m

ths

6 m

ths

12 m

ths

18 m

ths

24 m

ths T0

3 m

ths

6 m

ths

12 m

ths

18 m

ths

24 m

ths T0

3 m

ths

6 m

ths

12 m

ths

18 m

ths

24 m

ths

Sensorial Affective Evaluative

0

0.1

0.2

0.3

0.4

0.5

0.6

MedtronicStJudeBSC

Results 2/2

p = n.s.

Repeated Measures ANOVA - IPQ dimensions

ConclusionsThe 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.

Thanks to Arpa foundation that help us in research

THANK YOU

www.neuromodulation.itg.decarolis@email.it