Pubblicazioni

Effectiveness of Repetitive Transcranial Magnetic Stimulation in Patients With Failed Back Surgery Syndrome: A Double-Blind Randomized Placebo-Controlled Study

C., Bursali; Ü., Özkan F.; Y., Kaysin M.; N., Dortcan; G., Külcü D.; I., Aktas

Abstract:

METHODS: In this double-blinded, randomized, placebo-controlled trial, 20 patients (aged 34–65 years) clinically diagnosed as FBSS who had a history of surgery for lumbar disc herniation with persistent back and leg pain were reviewed. Only patients with no root compression and/or spinal stenosis in postoperative magnetic resonance imaging of lumbar spine were included. Patients were randomly assigned to r-TMS (n:10) and sham (n:10) groups. Patients in the r-TMS group received 5 Hz of r-TMS as a 20-minute (1,000 pulses) daily session, 5 days per week, for a total of 10 sessions. r-TMS was applied with MagVenture device (MagPro X100, Denmark, 2009) and figure 8 coil (MMC 140 parabolic, MagVenture). Control group received sham r-TMS with the same protocol. Each patient was evaluated at baseline, days 5 and 10 of treatment, and 1 and 3 months after treatment. Visual Analog Scale (VAS), DN4 (Douleur Neuropathique en 4 Questions), Oswestry Disability Index (ODI), Beck Depression Inventory (BDI), and the Pittsburgh Sleep Quality Index (PSQI) were used for evaluation. RESULTS: There were no statistically significant differences between the groups for age, gender, number of surgeries, pain duration, working status, and drug usage. Significant improvements were achieved in DN4, ODI, BDI, and PSQI scores in the r-TMS group in comparison to the sham group. Both groups displayed improvements in VAS scores, whereas improvement in the sham group was limited to the first month. Achieved improvements in the r-TMS group in terms of VAS, DN4, ODI, BDI, and PSQI scores were sustained at the third month.

Patologie/Applicazioni:

• Terapia del dolore
• Stimolazione Magnetica Transcranica (TMS)

Anno:

2021

Tipo di pubblicazione:

Articolo

Parola chiave:

rTMS; FBSS; dolore neuropatico; MagVenture

Testata scientifica:

Pain Physician

Nota:

Studio condotto su 20 pazienti affetti da dolore cronico connesso alla sindrome da fallimento chirurgico spinale (FBSS). 10 sono stati trattati con rTMS sull'area motoria primaria a 5 Hz per 10 sessioni e 10 hanno ricevuto sham TMS. La stimolazione è stata eseguita con uno strumento MagPro X100 e un coil MMC-140 della MagVenture. I dati raccolti in cinque fasi - al basale, al quinto, al decimo giorno e a 1 e 3 mesi dall’ultimo trattamento - dimostrano che la rTMS nei pazienti con FBSS porta a un netto miglioramento del dolore neuropatico connesso. Si evidenziano notevoli migliorie nelle scale VAS (per riposo, attività e dolore notturno), ODI, PSQI e BDI le quali dimostrano che la rTMS porta significativi miglioramenti della FBSS e che può quindi essere utilizzata per il trattamento di tale patologia.

DOI:

PMID: 33400434