This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Lamé, I. E. Articles by van Kleef, M. Search for Related Content PubMed Articles by Lamé, I. E. Articles by van Kleef, M. Related Collections Neuroanesthesia Preoperative Evaluation Outcomes Patient Safety Pain

---

ANALGESIA

Can the Outcome of Spinal Cord Stimulation in Chronic Complex Regional Pain Syndrome Type I Patients Be Predicted by Catastrophizing Thoughts?

Inge E. Lamé, PhD^*, Madelon L. Peters, PhD, Jacob Patijn, MD, PhD^*, Alfons G. Kessels, MD, MSc, José Geurts, MSc^*, and Maarten van Kleef, MD, PhD^*

From the *Department of Pain Management and Research Centre, University Hospital Maastricht; Department of Clinical Psychological Science, University Maastricht; and Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, Maastricht, The Netherlands.

Address correspondence and reprint requests to Inge E. Lamé, MSc, Pain Management and Research Centre, University Hospital Maastricht, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Address e-mail to ingelame{at}telfort.nl, sandra.reijnders{at}mumc.nl.

Abstract

BACKGROUND: In this study, we examined whether pain catastrophizing is a predictor of spinal cord stimulation (SCS) outcome in patients with complex regional pain syndrome type I (CRPS-I).

METHODS: Participants in this prospective cohort study were 32 patients with chronic CRPS-I, who received permanent SCS after a positive response to test stimulation. Baseline assessment was performed before test stimulation and included questions on demographic variables, disease information, pain intensity, pain catastrophizing, and health-related quality of life (QOL). Follow-up assessment was performed 9 mo after final implantation and included pain intensity, global perceived effect (GPE), and QOL. Successful SCS outcome was defined as a reduction of pain intensity of at least 50% on a visual analog scale or "much improved" or "total pain relief" on GPE.

RESULTS: After 9 months, 38% of the patients had a successful outcome in reduced pain intensity and 53% of the patients in GPE. In addition, improvements were apparent on several of the domains of QOL. However, no evidence was found for the predictive value of pain catastrophizing on the efficacy of SCS in reduction of pain intensity, GPE, or QOL.

CONCLUSIONS: This study showed that the efficacy of SCS in reduction of pain intensity, GPE, and QOL in a well-defined chronic CRPS-I population was not predicted by pain catastrophizing. Therefore, we conclude that a high level of pain catastrophizing in patients with CRPS-I is not a contraindication for SCS treatment.