Hyperuricemia Obstructs the Effect of Spinal Cord Stimulation on Peripheral Arterial Occlusive Diseases: The Retrospective Analysis of Eleven Cases
|Sumihisa Aida1*, Zen’ichiro Wajima2,3, Toshiya Shiga4, Kanta Kido5 and Eiji Masaki5|
|1Department of Pain Medicine, Nippori-Jogu Hospital, Tokyo, Japan|
|2Department of Anesthesiology, Shioya Hospital, International University of Health and Welfare, Tochigi, Japan|
|3Department of Anesthesiology, International University of health and Welfare Hospital, Tochigi, Japan|
|4Department of Anesthesiology, Kaken Hospital, International University of Health and Welfare, Chiba, Japan|
|5Division of Dento-oral Anesthesiology, Tohoku University Graduate School of Dentistry, Sendai, Japan|
|Corresponding Author :||Sumihisa Aida
Tokyo 204-0023, Japan
E-mail: [email protected]
|Received November 12, 2014; Accepted November 20, 2014; Published November 22, 2014|
|Citation: Aida S, Wajima Z, Shiga T, Kido K, Masaki E (2014) Hyperuricemia Obstructs the Effect of Spinal Cord Stimulation on Peripheral Arterial Occlusive Diseases: The Retrospective Analysis of Eleven Cases. J Pain Relief 3:164. doi: 10.4172/2167-0846.1000164|
|Copyright: © 2014 Aida S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.|
The indication of spinal cord stimulation (SCS), a treatment for intractable pain, has been expanded to include pain due to peripheral arterial occlusive disease (PAOD). However, its effectiveness may be influenced by the presence of some medical backgrounds. Then, the influences were analyzed in the current study, which identifyed an obstacle for effectiveness of SCS on PAOD.
Eleven patients with PAOD underwent implantation of a SCS device. The Fontaine’s stages (FSs) of all patients before the implantation (pre-FS) were III (4 cases) or IV (7 cases). The relationship between FS 6 months post implantation (post-FS) and the patients’ background, including age, duration of SCS introduction, chronic renal failure (CRF), diabetes mellitus (DM), hypertension, hyperuricemia (HU), hypercholesterolemia (HC), height, and body weight were retrospectively assessed.
The effect of SCS on PAOD varied among the 11 patients and was not significant. However, a significant Spearman correlation (r=0.7144, p=0.0182) between post-FS and the serum value of uric acid (UA) was demonstrated. Furthermore, the effectiveness of SCS was significant (p=0.0313) in the 6 patients with normouricemia (NU) when comparing the pre- vs. post-FS, and both post-FSs differed significantly (p=0.0065) when comparing NU vs. HU patients. In contrast, the improvement was null in the other 5 patients with HU. There were neither significant changes nor correlations between post-FS and all of the other background characteristics that were assessed.
Considering that SCS improved FS, both pain scores and tissue blood flow were improved. SCS is an effective treatment for patients with PAOD; however, the results differed depending on the presence of NU or HU. Thus, UA is suggested to be a marker of PAOD or a predictor of its prognosis.