Application Spinal Chord Stimulation (SCS) for management Tromboangiitis obliterans (Burger disease). Clinical observation study - 05/03/26
Cet article a été publié dans un numéro de la revue, cliquez ici pour y accéder
Highlights |
• | 264.5% improvement in pain-free walking distance (p = 0.05) with SCS in TAO; |
• | 80% ulcer healing rate and 10% amputation rate at 33-month follow-up; |
• | First study to document orthostatic perfusion changes (TcPO₂ +39.5%, LDF + 39.5%); |
• | Proposes collateral flow activation as key mechanism for tissue salvage; 68.5% improvement in resting TcPO₂ (p = 0.5) despite unchanged microcirculatory flow; |
• | Safe and effective for young TAO patients unresponsive to revascularization. |
Abstract |
Objectives |
This study aimed to evaluate the efficacy of spinal cord stimulation (SCS) in improving tissue perfusion and functional outcomes in patients with thromboangiitis obliterans (TAO), while assessing its impact on ulcer healing and amputation rates.
Methods |
This single-center retrospective study analyzed 10 TAO patients undergoing SCS implantation (2015-2024). Perfusion parameters (TcPO₂, LDF) were assessed at rest and during orthostatic test, with pain-free walking distance measured pre- and postoperatively. Inclusion required Fontaine stage ≥ IIb, failed revascularization/conservative therapy, and efficient trial stimulation (≥50% VAS reduction or ≥20% walking distance improvement).
Results |
SCS implantation yielded significant improvements across multiple parameters. Pain-free walking distance increased by 264.5% (p = 0.05), while tissue perfusion showed differential enhancement: resting TcPO₂ improved by 68.5% (p = 0.5) with stable LDF values (p = 0.39), whereas orthostatic testing demonstrated 39.5% TcPO₂ (p = 0.46) and 39.5% LDF (p = 0.42) improvements. Fontaine stage improved in 60% of patients, with 80% ulcer healing and 10% amputation rates observed during follow-up.
Conclusion |
Spinal cord stimulation shows promise as a safe and effective treatment for thromboangiitis obliterans, improving walking capacity, tissue perfusion, and ulcer healing while reducing amputation rates. These findings support SCS as a viable therapeutic option for TAO patients unresponsive to standard therapies.
Le texte complet de cet article est disponible en PDF.Keywords : Spinal cord stimulation, SCS, thromboangiitis obliterans, Buerger's disease
Plan
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?