Spinal Cord Stimulation (SCS) in Peripheral Ischemic Pain


Address for reprints: Dr. Dario Fiume, Via Bradano 24, 00199 Rome, Italy.


Between 1982 and 1987,45 patients suffering from painful symptomatology caused by peripheral vascular disease, not curable by medical or surgical therapy, were implanted with epidural neurological stimulators. Measurements used in evaluating the effectiveness of the method were pain control, walking distance, and development of trophic problems. With most patients, we noted a satisfactory and long-lasting degree of pain control. Walking distance increased to a surprising degree. Trophic lesions smaller than 3 sq cm healed, while lesions of greater size required amputation of the limb. Transcutaneous oxygen tension (TcpO2) was used to study the efects of SCS on peripheral circulation in implanted patients. In addition, TcpO2 was calculated in 15 patients before and during the percutaneous test to predict the efectiveness of SCS. Regression of painful symptomatology was achieved only in patients whose TcpO2b improved during the course of the testing. Therefore, this method provides an objective measure for the implantation of a neurostimulator