Novel pain therapy system manages patients with chronic
neuropathic pain
21 May 2013
A study investigating the safety and performance of Spinal
Modulation Inc's Axium Spinal Cord Stimulator (SCS) System has shown
that after 6 months of treatment 70% of patients suffering from leg
pain and 89% of patients suffering from foot pain reported
clinically significant pain relief. [1]
The Axium Spinal Cord Stimulator (SCS) System is aimed at
relieving chronic pain experienced by patients suffering from
long-term nerve damage following surgery (chronic post surgical
pain), complex regional pain syndrome (CRPS), amputation pain, or
failed back surgery syndrome (FBSS).
Chronic
post surgical pain is caused by nerve damage resulting from a
surgical procedure, for example inguinal hernia repair. If nerves
are damaged during surgery some patients may develop long-term
neuropathic pain. The number of people suffering from neuropathic
pain and chronic post surgical pain is not well documented. However,
it is estimated that 30-50% of patients after amputation, 20-30% of
women after mastectomy or lumpectomy, and 10% of patients after
inguinal hernia repair suffer from chronic post surgical pain.
“Instead of stimulating the back of the spinal cord, we can now
stimulate important branches of the spinal cord, the Dorsal Root
Ganglia (DRG). This small move laterally from the spinal cord to the
DRG represents a leap forward in pain management. We now have a tool
to treat focal areas of pain after injuries such as neuropathic foot
pain, neuropathic knee pain, and groin pain after hernia repair or
vascular access with minimal side effects such as unwanted
stimulation, postural effects when moving, and lead migration which
is common in traditional spinal cord stimulation,” said Dr
Liong
Liem, lead author and consultant in anaesthesiology and pain
medicine at St Antonius Hospital, Nieuwegein, The Netherlands.
Key results of the study published in include:
- 89% of patients with foot pain were experiencing greater
than 50% pain relief at 6 months;
- Patients did not experience significant positional effects
from stimulation when standing or lying down, which is a common
side effect of traditional spinal cord stimulation;
- Leads were stable over a six month period with only 2% lead
migration (2 out of 67). This is compared to 13.2% average
migration from 51 literature reviews of traditional spinal cord
stimulation;
- Quality of life as measured by the EQ-5D improved from
0.289±0.054 (N=20) and 0.725±0.066 (N=15), respectively. The
increase in the index value was statistically significant
(p<0.001);
- Pain severity scores were 6.9 (±0.2) at baseline and were
significantly reduced during the study, with levels reaching 3.9
(±0.6) at 6 months (p<0.001);
- Pain interference as described by the BPI improved from 6.6
(±0.4) at baseline to 4.1 (±0.5) (p<0.001), and maintained this
level through 6 months post-implant;
- 2/3 of the patients suffering from back and leg pain were
experiencing greater than 50% pain relief at 6 months.
"In my experience this novel approach to chronic pain management
offers an important new option for patients suffering from chronic
neuropathic pain. The Axium SCS System is associated with
minimal
side effects and has already advanced my ability to assist long
suffering and difficult-to-treat patients across Europe.” said Prof
Frank J Huygen, author and Professor of Anaesthesiology Erasmus
University, Rotterdam, The Netherlands.
References
1. Liong L et al. A multicenter, prospective trial to
assess the safety and performance of the spinal modulation dorsal
root ganglion neurostimulator system in the treatment of chronic
pain. Neuromodulation: Technology at the Neural Interface.
Article first published online: 13 May 2013 DOI: 10.1111/ner.12072
The abstract is available at:
http://onlinelibrary.wiley.com/doi/10.1111/ner.12072/abstract