Beneficial Therapeutic Effects of Spinal Cord Stimulation in Advanced Cases of Parkinson's Disease With Intractable Chronic Pain: A Case Series.

ABSTRACT

OBJECTIVES: Pain is one of the common symptoms in patients with Parkinson's disease (PD), with a prevalence of approximately 40-85%. These symptoms affect the quality of life of PD patients. We evaluated the effect of spinal cord stimulation (SCS) to chronic pain and motor symptoms of PD. MATERIALS AND METHODS: Three PD patients were treated with SCS to relieve their persistent and intractable pain. One patient had failed back surgery syndrome and the other two had lumbar canal stenosis. All patients had a stooped posture and pain that was resistant to analgesics. We evaluated motor symptoms using Hoehn and Yahr scale and the Unified Parkinson's Disease Rating Scale (UPDRS), and evaluated pain using visual analog scale and widespread pain index, before and after SCS. RESULTS: After SCS insertion, chronic pain in the patients decreased in both the lower back and limbs. Moreover, SCS ameliorated the symptoms of PD. One-year follow-up after SCS showed that UPDRS part III scores, rigidity, and tremor were improved without large alterations in levodopa dosage. Dementia and activities of daily living did not improve after SCS. DISCUSSION AND CONCLUSION: Our results indicate that SCS may be a treatment option for both motor symptoms and chronic pain in PD, especially in cases complicated with lumbar canal stenosis or disc herniation. Further studies are needed to evaluate the efficacy of SCS in PD patients.