PDF(Pubmed)
Abstract：
UNASSIGNED: Visceral pain, characterized by pain that is diffuse and challenging to localize, occurs frequently and is difficult to treat. In cases where the pain becomes intractable despite optimal medical management, it can affect patients\' Quality of Life (QoL). Spinal Cord Stimulation (SCS) has emerged as a potential solution for intractable visceral pain.
UNASSIGNED: In this narrative review, we collected all evidence regarding the efficacy of SCS for visceral pain across various underlying conditions.
UNASSIGNED: A comprehensive literature search was conducted in PubMed, Embase, and Web of Science in which articles published from October 1st, 1963 up to March 7th, 2023 were identified.
UNASSIGNED: Seventy articles were included in this review of which most were retrospective cohort studies, case series and case reports. The studies, often with a small number of participants, reported on SCS for chronic pancreatitis, anorectal pain and bowel disorders, gynaecological diagnoses, visceral pelvic pain, urological disorders and finally general visceral pain. They found positive effects on pain and/or symptom relief, opioid consumption, anxiety and depression and QoL. Complications occurred frequently but were often minor and reversible.
UNASSIGNED: Better screening and selection criteria need to be established to optimally evaluate eligible patients who might benefit from SCS. A positive outcome of a sympathetic nerve block appears to be a potential indicator of SCS effectiveness. Additionally, women receiving SCS for endometriosis had a better outcome compared to other indications. Finally, SCS could also relief functional symptoms such as voiding problems and gastroparesis. Complications could often be resolved with revision surgery. Since SCS is expensive and not always covered by standard health insurance, the incorporation of cost-analyses is recommended. In order to establish a comprehensive treatment plan, including selection criteria for SCS, rigorous prospective, possibly randomized and controlled studies that are diagnosis-oriented, with substantial follow-up and adequate sample sizes, are needed.
UNASSIGNED: In this narrative review, we collected all evidence regarding the efficacy of SCS for visceral pain across various underlying conditions.
UNASSIGNED: A comprehensive literature search was conducted in PubMed, Embase, and Web of Science in which articles published from October 1st, 1963 up to March 7th, 2023 were identified.
UNASSIGNED: Seventy articles were included in this review of which most were retrospective cohort studies, case series and case reports. The studies, often with a small number of participants, reported on SCS for chronic pancreatitis, anorectal pain and bowel disorders, gynaecological diagnoses, visceral pelvic pain, urological disorders and finally general visceral pain. They found positive effects on pain and/or symptom relief, opioid consumption, anxiety and depression and QoL. Complications occurred frequently but were often minor and reversible.
UNASSIGNED: Better screening and selection criteria need to be established to optimally evaluate eligible patients who might benefit from SCS. A positive outcome of a sympathetic nerve block appears to be a potential indicator of SCS effectiveness. Additionally, women receiving SCS for endometriosis had a better outcome compared to other indications. Finally, SCS could also relief functional symptoms such as voiding problems and gastroparesis. Complications could often be resolved with revision surgery. Since SCS is expensive and not always covered by standard health insurance, the incorporation of cost-analyses is recommended. In order to establish a comprehensive treatment plan, including selection criteria for SCS, rigorous prospective, possibly randomized and controlled studies that are diagnosis-oriented, with substantial follow-up and adequate sample sizes, are needed.
摘要：
■内脏疼痛，其特征是疼痛是弥漫性的，难以定位，经常发生并且难以治疗。在疼痛变得棘手的情况下，尽管有最佳的医疗管理，它会影响患者的生活质量（QoL）。脊髓刺激（SCS）已成为顽固性内脏疼痛的潜在解决方案。
■在这篇叙述性评论中，我们收集了关于SCS治疗各种基础疾病的内脏痛疗效的所有证据.
■在PubMed进行了全面的文献检索，Embase,和WebofScience，其中从10月1日起发表的文章，1963年至3月7日,2023年已确定。
■本综述包括70篇文章，其中大多数是回顾性队列研究，病例系列和病例报告。研究,通常只有少数参与者，关于慢性胰腺炎的SCS报告，肛门直肠疼痛和肠道疾病，妇科诊断，内脏盆腔疼痛,泌尿系统疾病，最后是一般内脏疼痛。他们发现了对疼痛和/或症状缓解的积极影响，阿片类药物的消费，焦虑、抑郁和QoL。并发症经常发生，但通常是轻微的和可逆的。
■需要建立更好的筛选和选择标准，以最佳地评估可能从SCS中受益的合格患者。交感神经阻滞的阳性结果似乎是SCS有效性的潜在指标。此外,与其他适应症相比,接受SCS治疗子宫内膜异位症的女性结局更好.最后,SCS还可以缓解功能症状，例如排尿问题和胃轻瘫。并发症通常可以通过翻修手术解决。由于SCS价格昂贵，而且并不总是由标准健康保险覆盖，建议纳入成本分析。为了树立周全的医治计划，包括SCS的选择标准，严谨的前瞻性，可能是以诊断为导向的随机对照研究，有大量的后续行动和足够的样本量，是需要的。
■在这篇叙述性评论中，我们收集了关于SCS治疗各种基础疾病的内脏痛疗效的所有证据.
■在PubMed进行了全面的文献检索，Embase,和WebofScience，其中从10月1日起发表的文章，1963年至3月7日,2023年已确定。
■本综述包括70篇文章，其中大多数是回顾性队列研究，病例系列和病例报告。研究,通常只有少数参与者，关于慢性胰腺炎的SCS报告，肛门直肠疼痛和肠道疾病，妇科诊断，内脏盆腔疼痛,泌尿系统疾病，最后是一般内脏疼痛。他们发现了对疼痛和/或症状缓解的积极影响，阿片类药物的消费，焦虑、抑郁和QoL。并发症经常发生，但通常是轻微的和可逆的。
■需要建立更好的筛选和选择标准，以最佳地评估可能从SCS中受益的合格患者。交感神经阻滞的阳性结果似乎是SCS有效性的潜在指标。此外,与其他适应症相比,接受SCS治疗子宫内膜异位症的女性结局更好.最后,SCS还可以缓解功能症状，例如排尿问题和胃轻瘫。并发症通常可以通过翻修手术解决。由于SCS价格昂贵，而且并不总是由标准健康保险覆盖，建议纳入成本分析。为了树立周全的医治计划，包括SCS的选择标准，严谨的前瞻性，可能是以诊断为导向的随机对照研究，有大量的后续行动和足够的样本量，是需要的。
