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Baclofen‐enhanced spinal cord stimulation and intrathecal baclofen alone for neuropathic pain: Long‐term outcome of a pilot study
Author(s) -
Lind Göran,
Schechtmann Gastón,
Winter Jaleh,
Meyerson Björn A.,
Linderoth Bengt
Publication year - 2008
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1016/j.ejpain.2007.03.011
Subject(s) - baclofen , neuropathic pain , medicine , anesthesia , intrathecal , spinal cord stimulation , spinal cord , stimulation , agonist , psychiatry , receptor
In a previously published pilot study, we addressed the possibility to increase the effectiveness of spinal cord stimulation (SCS) applied for neuropathic pain by using adjunct pharmacological therapy. This combined treatment approach was a direct spin‐off from animal experiments aiming at the exploration of transmitter and receptor mechanisms involved in the pain relieving effect of SCS. Out of 48 patients with neuropathic pain of peripheral origin responding poorly to SCS, seven received pumps for intrathecal baclofen (GABA‐B receptor agonist) delivery together with SCS, and four had pumps alone. In order to assess the long‐term effect a follow‐up has been performed, with an average, total treatment time of 67 months. At the follow‐up the remaining nine patients still enjoy about the same pain relief as initially, but with a mean, further dose increase of about 30%. This study demonstrates that a deficient SCS effect in neuropathic pain may be considerably improved by intrathecal baclofen administration, and that this enhanced effect persists for a long‐time. On‐going and future animal studies may provide new and even more efficient pharmaceutical candidates for such combined therapy.