Spinal stimulation relieves pain in patients with lower-limb ischemia

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Spinal cord stimulation (SCS) reduces pain and increases quality of life in hemodialysis patients with critical lower-limb ischemia, according to Italian researchers.

Investigator Dr. Mario Bonomini told Reuters Health that "implantation of an SCS device in patients with end-stage renal disease and critical limb ischemia might delay the appearance of ischemic skin lesions and amputation."

"The timing of stimulator implantation appears of critical importance for clinical outcome, " he added, "since no major benefits were observed in patients with the more advanced stage of chronic lower-extremity ischemia."

Peripheral artery occlusive disease is common in patients with end-stage renal disease, Dr. Bonomini of Ospedale Clinicizzato SS Annunziata, Chieta and colleagues note in the May issue of the American Journal of Kidney Diseases. Some patients, they add, are not candidates for primary surgical or angioplastic intervention may have to undergo amputation.

To determine if SCS might help avoid amputation in these circumstances, the researchers implanted the devices into 8 hemodialysis patients with renal failure and lower-limb ischemia.

Follow-up for as long as 1 year, showed that there were no complications from implantation and the patients' intensity of pain and quality of life improved considerably. The amount of pain medication was also reduced.

In addition there was no amelioration of ischemic skin lesion present before implantation. However no new lesions developed during the study period.

The researchers conclude that implantation of this device "dramatically improves quality of life and pain relief " and may help certain patients delay or avoid amputation.