Global usage of spinal cord stimulation therapy for chronic pain syndromes: a systematic review and meta-analysis.

IF 3.5 2区 医学 Q1 ANESTHESIOLOGY
Peter D Vu, Noushad Mamun, Lei Feng, Kathryn J Krause, Billy Huh, Ryan S D'Souza, Saba Javed
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引用次数: 0

Abstract

Background/importance: Spinal cord stimulation (SCS) is an established therapy for chronic pain conditions when conventional treatments fail. However, global research implementation varies significantly due to patient demographics, healthcare infrastructure, and economic factors, creating disparities in access that directly impact patient care and public health outcomes.

Objective: To evaluate the global landscape of SCS research by analyzing patient demographics, geographic distribution, funding sources, and pain conditions treated across chronic pain populations aged 18 years and older, with primary focus on associations between geographic regions and patient age demographics.

Evidence review: We conducted a systematic literature review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, searching five major databases through October 2024. Studies from 2000 onward reporting SCS in adults with chronic pain lasting 3 months or longer were included. We included randomized trials, comparative studies, and case series with at least 10 patients, excluding commentaries, reviews, and insurance databases.

Findings: Analysis of 187 studies revealed heterogeneity in age distributions across geographic regions, with Asian studies showing higher mean ages compared to North America, while European showed lower mean ages. Research concentration was predominantly in high-income regions, with 57% of studies receiving industry funding and significant associations between funding source and geographic origin. Post-surgical pain syndrome-thoracolumbar emerged as the most prevalent condition globally, representing 44.9% of cases.

Conclusions: Significant associations exist between geographic regions and patient demographics in SCS research, with notable disparities in research concentration highlighting the need for broader investigation in underrepresented areas to optimize global application of this chronic pain management therapy.

Prospero registration number: CRD42025635147.

脊髓刺激治疗慢性疼痛综合征的全球应用:系统回顾和荟萃分析。
背景/重要性:当常规治疗失败时,脊髓刺激(SCS)是一种成熟的治疗慢性疼痛的方法。然而,由于患者人口统计、医疗基础设施和经济因素,全球研究实施情况差异很大,造成了直接影响患者护理和公共卫生结果的获取差异。目的:通过分析18岁及以上慢性疼痛人群的患者人口统计学、地理分布、资金来源和疼痛状况,评估SCS研究的全球格局,主要关注地理区域与患者年龄人口统计学之间的关系。证据回顾:我们按照系统回顾和荟萃分析(PRISMA)指南的首选报告项目进行了系统文献回顾和荟萃分析,检索了五个主要数据库,截至2024年10月。2000年以后的研究报告了持续3个月或更长时间的成人慢性疼痛的SCS。我们纳入了至少10例患者的随机试验、比较研究和病例系列,排除了评论、评论和保险数据库。研究结果:对187项研究的分析显示,不同地理区域的年龄分布存在异质性,亚洲研究的平均年龄高于北美,而欧洲研究的平均年龄较低。研究主要集中在高收入地区,57%的研究获得了行业资助,资金来源与地理来源之间存在显著关联。术后疼痛综合征-胸腰椎成为全球最常见的疾病,占44.9%。结论:在SCS研究中,地理区域和患者人口统计学之间存在显著关联,研究集中存在显著差异,强调需要在代表性不足的地区进行更广泛的调查,以优化这种慢性疼痛管理疗法的全球应用。普洛斯彼罗注册号:CRD42025635147。
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
CiteScore
8.50
自引率
11.80%
发文量
175
审稿时长
6-12 weeks
期刊介绍: Regional Anesthesia & Pain Medicine, the official publication of the American Society of Regional Anesthesia and Pain Medicine (ASRA), is a monthly journal that publishes peer-reviewed scientific and clinical studies to advance the understanding and clinical application of regional techniques for surgical anesthesia and postoperative analgesia. Coverage includes intraoperative regional techniques, perioperative pain, chronic pain, obstetric anesthesia, pediatric anesthesia, outcome studies, and complications. Published for over thirty years, this respected journal also serves as the official publication of the European Society of Regional Anaesthesia and Pain Therapy (ESRA), the Asian and Oceanic Society of Regional Anesthesia (AOSRA), the Latin American Society of Regional Anesthesia (LASRA), the African Society for Regional Anesthesia (AFSRA), and the Academy of Regional Anaesthesia of India (AORA).
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