+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

High Level of Childhood Trauma Predicts a Poor Response to Spinal Cord Stimulation in Chronic Neuropathic Pain

High Level of Childhood Trauma Predicts a Poor Response to Spinal Cord Stimulation in Chronic Neuropathic Pain

Pain Physician 22(1): E37-E44

Spinal cord stimulation (SCS) relieves pain by delivering doses of electric current to the dorsal column of the spinal cord and has been found to be most effective in the treatment of neuropathic pain. Psychological distress is a significant risk factor for the development of chronic pain and has been found to affect the outcome of SCS. Childhood trauma is a risk factor for chronic pain, but has not previously been studied in SCS patients. The objective of this prospective registry-based study was to investigate the prevalence of 5 domains of childhood trauma (emotional neglect, emotional abuse, physical neglect, physical abuse, and sexual abuse) and their relationship with the outcome of spinal cord stimulation on patients suffering from treatment-resistant chronic pain. SCS patients treated at Kuopio University Hospital between 1/1/2015 and 12/31/2016 were sent a survey in the mail, the Trauma and Distress Scale, assessing childhood trauma (n = 43). Neuropathic pain, disability, anxiety, and depression were measured in the patients pre-surgery and at 6 and 12 months post-surgery. The patients who provided their name on the questionnaire (n = 22) and had suffered from 3 or more domains of trauma were grouped as the high-trauma group (n = 13) and the rest as the low-trauma group (n = 9). The questionnaire was completed by 40 patients (93%). At least 1 domain of trauma was experienced by 35 (88%) patients, and at least 2 by 24 (60%). The low-trauma group displayed a statistically significant decrease in the mean PainDETECT score from 21.5 before SCS to 16.5 at 12 months post-surgery (Wilk's lambda = 0.297, F(2,9) = 10.6, P = 0.004), contrary to the high- trauma group (Wilk's lambda = 0.904, F(2,6) = 0.3, P = 0.739). Only 22 of the 40 patients provided their name on the questionnaire, which decreased the sample size on follow-up. This was the first study to investigate childhood trauma in SCS patients. Patients who had experienced high amounts of childhood trauma did not experience any relief from neuropathic pain 12 months' post-SCS, contrary to the low-trauma group. Childhood trauma might be a factor worth screening in the preoperative evaluation and aftercare of SCS candidates. Spinal cord stimulation, the Trauma and Distress Scale, chronic pain, childhood trauma, childhood abuse, childhood neglect, chronic back pain, back pain, psychological distress, neuropathic pain.

Please choose payment method:

(PDF emailed within 1 workday: $29.90)

Accession: 066445043

Download citation: RISBibTeXText

PMID: 30700077

Related references

Chronic neuropathic pain in spinal cord injury: efficiency of deep brain and motor cortex stimulation therapies for neuropathic pain in spinal cord injury patients. Annals of Physical and Rehabilitation Medicine 52(2): 188-193, 2010

High-Frequency Spinal Cord Stimulation at 10 kHz for the Treatment of Chronic Neuropathic Pain After a II-III Degree Burn. Pain Medicine 18(9): 1826-1828, 2017

Treatment of Chronic Refractory Neuropathic Pelvic Pain with High-Frequency 10-kilohertz Spinal Cord Stimulation. Pain Practice 18(6): 805-809, 2017

The chronic neuropathic pain of spinal cord injury: which efficiency of neuropathic stimulation?. Annals of Physical and Rehabilitation Medicine 52(2): 180-187, 2010

Altering Conventional to High Density Spinal Cord Stimulation: An Energy Dose-Response Relationship in Neuropathic Pain Therapy. Neuromodulation 20(1): 71-80, 2016

Spinal cord stimulation in chronic neuropathic pain. Lakartidningen 88(9): 727-732, 1991

Dynamic Changes in Nociception and Pain Perception After Spinal Cord Stimulation in Chronic Neuropathic Pain Patients. Clinical Journal of Pain 31(12): 1046-1053, 2016

Spinal cord stimulation in a mouse chronic neuropathic pain model. Neuromodulation 10(4): 358-362, 2007

Managing chronic neuropathic pain: the role of spinal cord stimulation. British Journal of Community Nursing 14(5): 207-209, 2009

The Usefulness of Spinal Cord Stimulation for Chronic Pain Due to Combined Vasospastic Prinzmetal Angina and Diabetic Neuropathic Pain of the Lower Limbs. Journal of Neurological Surgery. Part A, Central European Neurosurgery 77(2): 176-178, 2016

The response of neuropathic pain and pain in complex regional pain syndrome I to carbamazepine and sustained-release morphine in patients pretreated with spinal cord stimulation: a double-blinded randomized study. Anesthesia and Analgesia 92(2): 488-495, 2001

Practice parameters for the use of spinal cord stimulation in the treatment of chronic neuropathic pain. Pain Medicine 8 Suppl 4: S200-S275, 2007

The effects of spinal cord stimulation in neuropathic pain are sustained: a 24-month follow-up of the prospective randomized controlled multicenter trial of the effectiveness of spinal cord stimulation. Neurosurgery 63(4): 762-70; Discussion 770, 2008

Spinal cord injury below-level neuropathic pain relief with dorsal root entry zone microcoagulation performed caudal to level of complete spinal cord transection. Journal of Neurosurgery. Spine 28(6): 612-620, 2018

Biomarkers for Chronic Neuropathic Pain and their Potential Application in Spinal Cord Stimulation: A Review. Translational Perioperative and Pain Medicine 1(3): 33-38, 2016