Is it possible to generate an additional pleasant and pain-relieving muscle stimulation when using a low-frequency spinal cord stimulation (SCS) for the treatment of lower back pain? Pilot study: A new technique: "MuscleSCS".

IF 2.5 3区医学 Q2 ANESTHESIOLOGY

Pain Practice Pub Date : 2024-03-01 Epub Date: 2023-12-06 DOI:10.1111/papr.13324

Matthias Hubert Morgalla, Justus Marquetand, Franziska Katharina Staber

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引用次数: 0

Abstract

Objective: The combined use of spinal cord stimulation (SCS) and muscle stimulation, in the treatment of chronic pain, using the same probe, could improve the clinical results. However, this technique has not been established as yet. It was our hypothesis that it is possible to generate muscle stimulation by using low frequencies with SCS electrodes and use it to additionally treat chronic back pain.

Methods: We generated muscle stimulation in patients with previously implanted SCS electrodes, for the treatment of lower back pain, by using low frequencies (2, 4, 6, and 8 Hz) and different contact combinations of the electrodes. The results were evaluated by using visual inspection (videos), haptic control, surface electromyography (EMG), and sonographic recordings.

Results: This pilot study (17 patients, seven females, age 36-87 years, 11 percutaneous paddle leads, and 6 octrodes) was performed at the Neurosurgical Department of the University of Tuebingen. The most preferred frequencies were 6 Hz (45.5% of percutaneous paddle leads) and 8 Hz (50% of octrodes) at contacts 3&4 or 5&6. The preference of frequencies differed significantly among genders (p = 0.023). Simultaneous EMG and ultrasonic recordings demonstrated the generation of muscle potentials and the stimulation of deeper muscle groups.

Conclusion: In this study, it has been shown that with low-frequency SCS stimulation, pleasant and pain-relieving muscle contractions of the lower and upper back can also be generated. This combined method has been coined by us as "MuscleSCS" technique. Clinical trials are necessary to establish the value of this combined technique and its subtypes.

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当使用低频脊髓刺激(SCS)治疗下背部疼痛时，是否有可能产生额外的愉快和缓解疼痛的肌肉刺激?初步研究:一种新技术:“肌肉cs”。

目的:脊髓刺激与肌肉刺激联合应用于慢性疼痛的治疗中，使用同一探针，可提高临床疗效。然而，这种技术还没有建立起来。我们的假设是，通过使用低频的SCS电极产生肌肉刺激，并将其用于治疗慢性背痛是可能的。方法:我们通过使用低频(2、4、6和8 Hz)和不同的电极接触组合，对先前植入SCS电极的患者进行肌肉刺激，以治疗下背部疼痛。结果通过视觉检查(视频)、触觉控制、表面肌电图(EMG)和超声记录进行评估。结果:这项初步研究(17例患者，7名女性，年龄36-87岁，11个经皮桨叶导联，6个电极)在图宾根大学神经外科进行。在接触3&4或5&6处，首选频率为6 Hz(经皮桨导联的45.5%)和8 Hz (octrodes的50%)。不同性别对频率的偏好差异显著(p = 0.023)。同时肌电图和超声记录显示肌肉电位的产生和对深层肌群的刺激。结论:本研究表明，在低频SCS刺激下，下背部和上背部也能产生愉快的、缓解疼痛的肌肉收缩。这种组合方法被我们称为“MuscleSCS”技术。临床试验是必要的，以确定这种联合技术及其亚型的价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pain Practice ANESTHESIOLOGY-CLINICAL NEUROLOGY

CiteScore

5.60

自引率

3.80%

发文量

审稿时长

6-12 weeks

期刊介绍： Pain Practice, the official journal of the World Institute of Pain, publishes international multidisciplinary articles on pain and analgesia that provide its readership with up-to-date research, evaluation methods, and techniques for pain management. Special sections including the Consultant’s Corner, Images in Pain Practice, Case Studies from Mayo, Tutorials, and the Evidence-Based Medicine combine to give pain researchers, pain clinicians and pain fellows in training a systematic approach to continuing education in pain medicine. Prior to publication, all articles and reviews undergo peer review by at least two experts in the field.