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高频 10 kHz 脊髓刺激治疗糖尿病性周围神经病理性疼痛的真实世界分析。

A Real-World Analysis of High-Frequency 10 kHz Spinal Cord Stimulation for the Treatment of Painful Diabetic Peripheral Neuropathy.

机构信息

Center for Pain, University of California San Diego, San Diego, CA, USA.

Loma Linda University, Loma Linda, CA, USA.

出版信息

J Diabetes Sci Technol. 2022 Mar;16(2):282-288. doi: 10.1177/19322968211060316. Epub 2021 Nov 29.

Abstract

BACKGROUND

Diabetes is one of the most prevalent chronic health conditions and diabetic neuropathy one of its most prevalent and debilitating complications. While there are treatments available for painful diabetic peripheral neuropathy (pDPN), their effectiveness is limited.

METHOD

This retrospective, multi-center, real-world review assessed pain relief and functional improvements for consecutive patients with diabetic neuropathy aged ≥18 years of age who were permanently implanted with a high-frequency (10 kHz) spinal cord stimulation (SCS) device. Available data were extracted from a commercial database.

RESULTS

In total 89 patients consented to being included in the analysis. Sixty-one percent (54/89) of participants were male and the average age was 64.4 years (SD = 9.1). Most patients (78.7%, 70/89) identified pain primarily in their feet or legs bilaterally. At the last assessment, 79.5% (58/73) of patients were treatment responders, defined as having at least 50% patient-reported pain relief from baseline. The average time of follow-up was 21.8 months (range: 4.3 to 46.3 months). A majority of patients reported improvements in sleep and overall function relative to their baseline.

CONCLUSIONS

This real-world study in typical clinical practices found 10 kHz SCS provided meaningful pain relief for a substantial proportion of patients refractory to current pDPN management, similar to published literature. This patient population has tremendous unmet needs and this study helps demonstrate the potential for 10 kHz SCS to provide an alternative pain management approach.

摘要

背景

糖尿病是最常见的慢性健康问题之一,而糖尿病周围神经病变是其最常见和最具致残性的并发症之一。虽然有治疗方法可用于治疗疼痛性糖尿病周围神经病变(pDPN),但其疗效有限。

方法

本回顾性、多中心、真实世界研究评估了对年龄≥18 岁、患有糖尿病周围神经病变且永久植入高频(10 kHz)脊髓刺激(SCS)装置的连续患者的疼痛缓解和功能改善情况。可获得的数据是从商业数据库中提取的。

结果

共有 89 名患者同意参与分析。61%(54/89)的参与者为男性,平均年龄为 64.4 岁(标准差=9.1)。大多数患者(78.7%,70/89)双侧足部或腿部疼痛为主。在最后一次评估时,79.5%(58/73)的患者为治疗应答者,定义为与基线相比至少有 50%的患者自述疼痛缓解。平均随访时间为 21.8 个月(范围:4.3 至 46.3 个月)。大多数患者报告与基线相比,睡眠和整体功能均有所改善。

结论

在典型的临床实践中,这项真实世界研究发现,10 kHz SCS 为相当一部分对当前 pDPN 管理无反应的患者提供了有意义的疼痛缓解,与已发表的文献相似。这一患者群体存在巨大的未满足需求,本研究有助于证明 10 kHz SCS 作为一种替代疼痛管理方法的潜力。

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Amelioration of lower limb pain and foot drop with 10 kHz spinal cord stimulation: A case series.
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