Reflex Sympathetic Dystrophy (RSD and CRPS) Reflex Sympathetic Dystrophy (Complex Regional Pain Syndromes Type I) and Causalgia (Complex Regional Pain Syndromes Type II)(RSD and CRPS)


advertisement
Reply
 
Thread Tools Display Modes
Old 10-20-2012, 12:07 PM #1
LIT LOVE LIT LOVE is offline
Magnate
 
Join Date: Mar 2010
Posts: 2,304
10 yr Member
LIT LOVE LIT LOVE is offline
Magnate
 
Join Date: Mar 2010
Posts: 2,304
10 yr Member
Default

Quote:
Originally Posted by Kevscar View Post
fmicheal
I read a paper a few months back that said 60% of all RSD sufferers who are given SCS's get RSD at the incision sites and pain relief only varies between 15 and 50%.
Not somethig I would ever consider although I have read posts by people saying that despite the new RSD they consider themselves to be in less pain than previously
Again, you're the only person I've ever seen claim such a study exists. link?
LIT LOVE is offline   Reply With QuoteReply With Quote
Old 10-20-2012, 05:16 PM #2
fmichael's Avatar
fmichael fmichael is offline
Senior Member
 
Join Date: Sep 2006
Location: California
Posts: 1,239
15 yr Member
fmichael fmichael is offline
Senior Member
fmichael's Avatar
 
Join Date: Sep 2006
Location: California
Posts: 1,239
15 yr Member
Default long term effectiveness of SCS

Quote:
Originally Posted by LIT LOVE View Post
Again, you're the only person I've ever seen claim such a study exists. link?
On reflection, this isn't the study you've requested, but goes to a fundamental point that is all too often ignored . . .

Spinal cord stimulation for chronic reflex sympathetic dystrophy--five-year follow-up, Kemler MA, de Vet HC, Barendse GA, van den Wildenberg FA, van Kleef M, N Engl J Med. 2006 Jun 1;354(22):2394-6, 96.

Academic Medical Center, Vrije Universiteit Medical Center, Amsterdam, and Maastricht University Hospital, Maastricht, the Netherlands
The long-term follow-up analysis demonstrates that the pain-alleviating effect of spinal cord stimulation in chronic reflex sympathetic dystrophy diminishes with time, as compared with that in a control group, and is no longer statistically significant after three years. [Emphasis added.]

But, see, Long-term outcomes of spinal cord stimulation with paddle leads in the treatment of complex regional pain syndrome and failed back surgery syndrome, Sears NC, Machado AG, Nagel SJ, Deogaonkar M, Stanton-Hicks M, Rezai AR, Henderson JM, Neuromodulation. 2011 Jul-Aug;14(4):312-8; discussion 318. doi: 10.1111/j.1525-1403.2011.00372.x. Epub 2011 Jul 7.

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
Abstract

INTRODUCTION: Spinal cord stimulation (SCS) is frequently used to treat chronic, intractable back, and leg pain. Implantation can be accomplished with percutaneous leads or paddle leads. Although there is an extensive literature on SCS, the long-term efficacy, particularly with paddle leads, remains poorly defined. Outcome measure choice is important when defining therapeutic efficacy for chronic pain. Numerical rating scales such as the NRS-11 remain the most common outcome measure in the literature, although they may not accurately correlate with quality of life improvements and overall satisfaction.

METHODS: We reviewed the medical records of patients with failed back surgery syndrome (FBSS) or complex regional pain syndrome (CRPS) implanted with SCS systems using paddle leads between 1997 and 2008 at the Cleveland Clinic with a minimum six-month follow-up. Patients were contacted to fill out a questionnaire evaluating outcomes with the NRS-11 as well as overall satisfaction.

RESULTS:A total of 35 eligible patients chose to participate. More than 50% of the patients with CRPS reported greater than 50% pain relief at a mean follow-up of 4.4 years. Approximately 30% of the FBSS patients reported a 50% or greater improvement at a mean follow-up of 3.8 years. However, 77.8% of patients with CRPS and 70.6% of patients with FBSS indicated that they would undergo SCS surgery again for the same outcome.

CONCLUSION: Patients with CRPS and FBSS have a high degree of satisfaction, indexed as willingness to undergo the same procedure again for the same outcome at a mean follow-up of approximately four years. The percentage of satisfaction with the SCS system is disproportionally greater than the percentage of patients reporting 50% pain relief, particularly among patients with FBSS. This suggests that the visual analog scale may not be the optimal measure to evaluate long-term outcomes in this patient population. [Emphasis added.]

© 2011 International Neuromodulation Society.

PMID: 21992424 [PubMed - indexed for MEDLINE]

Unfortunately, the abstract to the article by Sears NC et al, doesn’t provide a link through which I could purchase it, so I have no way to comment on its methodology, etc. The latter is a particular concern where an "n of 35 eligible patients" is a remarkably small number, in light of the number of SCS implantation procedures on CRPS patients done by the two institutions - including The Cleveland Clinic - over the relevant 11-year time period, certainly numbering well into the hundreds.

Finally, it should be born in mind, that, while Kemler et al reported on a bona fide longitudinal study - which found its way into the NEJM - the report out of Cleveland is based solely on those patients who chose to respond to a survey questionnaire, which may explain while it was published in Neuromodulation, the journal of the International Neuromodulation Society, which describes the “Scope of Neuromodulation Advances” as follows:
Neuromodulation employs advanced medical device technologies to enhance or suppress activity of the nervous system for the treatment of disease. These technologies include implantable as well as non-implantable devices that deliver electrical, chemical or other agents to reversibly modify brain and nerve cell activity.
In other words, it’s a trade journal.


Mike


PS And my apologies f I missed an earlier request for the citation.
__________________
I have learned that to be with those I like is enough.

- Walt Whitman

Last edited by fmichael; 10-20-2012 at 08:12 PM. Reason: (re-read the question)
fmichael is offline   Reply With QuoteReply With Quote
"Thanks for this!" says:
AintSoBad (07-12-2013), LIT LOVE (10-21-2012)
Old 10-20-2012, 08:54 PM #3
Kevscar
Guest
 
Posts: n/a
Kevscar
Guest
 
Posts: n/a
Default

LIT LOVE
Checked 120 plus links in my favoutiresand 150 + documents I have downloaded and I don't have it probably because from the amount of posts I have read I thought it was around 50% anyway.
You can choose to believe me or not but here are 3 things I know which I'll bet the vast majority of forum members have never heard of before.
There are 2 different versions of RSD?CRPS type 1 and the second has to be treated differently.
A Paper saying that there is growing evidence doctors have been looking in the wrong direction for 65 years and sympathetic reflexs may not be the cause.
7-8% of us may get wounds that never heal.
Tell me which ones you have never heard of and I'll post links
  Reply With QuoteReply With Quote
Old 10-20-2012, 11:47 PM #4
LIT LOVE LIT LOVE is offline
Magnate
 
Join Date: Mar 2010
Posts: 2,304
10 yr Member
LIT LOVE LIT LOVE is offline
Magnate
 
Join Date: Mar 2010
Posts: 2,304
10 yr Member
Default

Quote:
Originally Posted by Kevscar View Post
LIT LOVE
Checked 120 plus links in my favoutiresand 150 + documents I have downloaded and I don't have it probably because from the amount of posts I have read I thought it was around 50% anyway.
You can choose to believe me or not but here are 3 things I know which I'll bet the vast majority of forum members have never heard of before.
There are 2 different versions of RSD?CRPS type 1 and the second has to be treated differently.
A Paper saying that there is growing evidence doctors have been looking in the wrong direction for 65 years and sympathetic reflexs may not be the cause.
7-8% of us may get wounds that never heal.
Tell me which ones you have never heard of and I'll post links
I'm not arguing that any of the info is correct or incorrect. The data is meaningless when quoted out of context, IMO. It is very easy to manipulate data. Were there 20 patients in the control sample or 2000... Etc.

Throwing out unrelated bits of information that have nothing whatsoever to do with the validity of a study you're quoting, but can't link to just confuses me further.

fMichael is a good role model for us all...not only does he cite his references, he breaks down potential concerns about the validity of certain data.
LIT LOVE is offline   Reply With QuoteReply With Quote
Old 10-21-2012, 04:22 AM #5
Kevscar
Guest
 
Posts: n/a
Kevscar
Guest
 
Posts: n/a
Default

Sorry if I got it wrong but it sounded as if you didn't believe the paper existed. I used it because the figure actually exceeded the 50% I had come to believe from the hundreds of posts I had read about it and why I said that many of those still felt they were better off even though it had spread. I have got so many links documtents and sites I have visited that it was impossible to keep everyone and I have no idea how many were involved.I have attached the 3 documents I talked about.
Dutch Guidelines also say that Amputation can be considered. This group is the most advanced and organised in the World. It is 5 university hospitals and 2 drug companies working together. There are 2 verisons of this, one for doctors one for patients. http://pdver.atcomputing.nl/english.html
The 2nd was publish by the American Pain Society http://www.thblack.com/links/RSD/JPa...2_CRPSname.pdf
The third, http://www.rsds.org/1/publications/r...pring2008.html I don't know how accurate the 7 - 8% is but I am one of them as the attached picture shows
Attached Images
File Type: jpg legforvideo.jpg (197.1 KB, 83 views)

Last edited by Kevscar; 10-21-2012 at 05:57 AM.
  Reply With QuoteReply With Quote
Reply


Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
need help finding a good neurosurgeon CarolynB12 New Member Introductions 1 03-31-2011 04:21 AM
finding the good old stuff annie Epilepsy 11 09-02-2006 11:22 PM


All times are GMT -5. The time now is 12:28 AM.

Powered by vBulletin • Copyright ©2000 - 2024, Jelsoft Enterprises Ltd.

vBulletin Optimisation provided by vB Optimise v2.7.1 (Lite) - vBulletin Mods & Addons Copyright © 2024 DragonByte Technologies Ltd.
 

NeuroTalk Forums

Helping support those with neurological and related conditions.

 

The material on this site is for informational purposes only,
and is not a substitute for medical advice, diagnosis or treatment
provided by a qualified health care provider.


Always consult your doctor before trying anything you read here.