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Spinal Cord Stimulation: Predictive Parameters of Outcome in Patients Suffering From Critical Lower Limb Ischemia. A Preliminary Study
Neuromodulation, 08/22/2011
Clinical Article
Colini-Baldeschi G et al. – Spinal neuromodulation is an effective therapy option in the management of patients affected by non–reconstructable chronic critical limb ischemia.
Methods- 40 patients, 16 female and 24 male, average age 69 ± 8, underwent microcirculatory screening with transcutaneous oximetry and dynamic capillaroscopy.
- Microcirculatory assessment was performed before temporary implantation of the spinal cord stimulation stimulator and after one month.
- Following metabolic parameters were considered: TcPO2–TcPCO2 and with dependent limb, difference between dependent limb and supine values ( Δ TcPO2, Δ TcPCO2), change in TcPO2–TcPCO2 after stimulation.
- Dynamic capillaroscopy parameters were recorded.
- Follow–up visits were scheduled at three, six, and twelve months after implantation.
- Procedure was performed placing an Octrode (St. Jude Medical, St. Paul, MN, USA) on the dorsal columns of the spinal cord.
- 2 groups were identified on the basis of transcutaneous oximetry measurements: group A (22 patients) and group B (18 patients), responding differently to the postural test.
- After one month of home testing period, there was an improvement in metabolic parameters, differing from one group to the other.
- Morphofunctional data provided by capillaroscopy highlighted the percentage of open capillaries poststimulation as being a significant parameter, although not mentioned in previous studies.
