Table 2.
Studies evaluating neuromodulation for the treatment of postamputation pain
| Implant type | Implant location | Study | Number of implants | Criteria for successful outcome | Follow-up | Successful outcomes |
|---|---|---|---|---|---|---|
| MCS, DBS, SCS | Epidural | Katayama et al108 | 19 | >80% improvement in VAS | 2–18 years | 6/19 SCS, 6/10 DBS, 1/5 MCS |
| MCS | Epidural | Sol et al109 | 3 | >70% improvement in VAS | 24–29 months | 2/3 |
| DBS | Periventricular gray/thalamus | Bittar et al110 | 3 | >50% improvement in VAS | 8–20 months | 3/3 |
| SCS | Subdural | Nielson et al98 | 6 | Subjective pain relief | 7–25 months | 4 excellent, 1 good |
| SCS | Subdural, endodural | Hunt et al100 | 5 | Excellent: complete pain relief Partial: incomplete pain relief | Not noted | 1 excellent, 1 partial, 3 no benefit |
| SCS | Epidural | Miles and Lipton101 | 9 | Excellent: no narcotics Some: need for occasional narcotics | 1 year | 6 excellent, 1 some, 2 none |
| SCS | Subdural, endodural | Krainick et al99 | 61 | % subjective pain relief | Not noted | 0% – 28 |
| 1%–25% – 7 | ||||||
| 26%–50% – 12 | ||||||
| 51%–75% – 13 | ||||||
| >75% – 1 | ||||||
| SCS | Epidural | Sanchez-Ledesma et al102 | 3 trials 6 implants | >75% subjective pain relief | 5.5 years | 57% met success criteria |
| SCS | Epidural | Broggi et al104 | 23 trials 26 implants | Verbally classified pain intensity >50%, life standard | 2 years | 58% met success criteria |
| SCS | Epidural | Kumar et al103 | 3 | >50% improvement subjective pain relief | 6 months to 15 years | 0 |
| SCS | Epidural | McAuley et al111 | 12 | >50% improvement VAS | 5–20 years | 5/12 |
| PNS | Brachial plexus, sciatic, femoral | Long112 | 4 | Satisfactory pain relief | 3–18 months | 2/4 |
| PNS | Sciatic | Nashold et al113 | 1 | Satisfactory pain relief | 8 years | 1/1 |
| PNS | Brachial plexus, sciatic, femoral | Campbell and Long114 | 6 | >50% subjective pain relief | 6–54 months | 0/6 |
| PNS | Femoral | Rauck et al97 | 1 | Mean pain interference scores, pain disability index | 8 weeks | 1/1 70% and 52% improvement |
Abbreviations: DBS, deep brain stimulator; MCS, motor cortex stimulator; PNS, peripheral nerve stimulator; SCS, spinal cord stimulator; VAS, Visual Analog Scale.