Three dimensional analysis of the effects of spinal cord stimulation on neuropathic pain and spastic lower-limb motor impairment: report of a patient

Abstract

Pain-alleviating effect of spinal cord stimulation (SCS) is established for neuropathic pain. Recent reports suggested beneficial effects of SCS on neurologic degenerative diseases, such as Parkinson disease. We report a 61-year-old man with degenerative spinal cord disorder causing spastic paraparesis of the lower limbs, who was treated with SCS. His capabilities of motor performances were evaluated with three dimensional optical motion-capture system. The patient also had severe low back pain resistant to medications. The pain intensity was 8 on an eleven-point numerical rating scale (NRS). The stimulating electrode of SCS was positioned at the level of 10th thoracic vertebra. The pain lessened to 5 on NRS after SCS. The time needed to standing from sitting position improved from 5.5±0.5 seconds before SCS to 4.0±0.1 seconds after SCS (P<0.05). The alignment of the pelvis and trunk became 10.0±6.8 degrees lordotic after SCS (P<0.05). His ambulation improved markedly. We conclude that SCS can not only improve pain but also motor function in some patients with degenerative spinal cord diseases. Three-dimensional optical motion-capture system is useful for objective evaluation of motor improvement.