Predictive Value of Transcutaneous Oxygen Tension Measurement in the Indication for Spinal Cord Stimulation in Patients with Peripheral Vascular Disease: Preliminary Results

Abstract

Thirteen patients (12 males, 1 fe male, mean age 60.5 years) affected by peripheral vascular disease (21 lower limbs: 9 with intermittent clau dication and 12 with rest pain and/or necrosis smaller than 3 cm 2 ) have been studied by means of transcuta neous oxygen tension (TcpO 2 ) mea surements. They had been submitted to spinal cord stimulation (SCS) de vice implant from one day to twenty- two months previously. In 8 patients (15 limbs) implanted from one day to twenty-two months, the TcpO 2 index was calculated to evaluate the neuro- stimulator effect on peripheral blood circulation. In 5 patients (6 limbs) studied before definitive implanta tion, preoperative and postoperative TcpO 2 measurements were able to predict the SCS efficacy during the temporary trial period: when TcpO 2 did not increase immediately (4 limbs), no result was achieved (am putation) ; a TcpO 2 increase corre sponded to relief of symptoms (2 limbs). On the basis of this preliminary report, TcpO 2 measurement could be useful for predicting SCS efficacy in vascular patients; the possibility of dividing the patients into responders and nonresponders to SCS by TcpO 2 measurement represents an impor tant achievement in determining the indication for SCS implant.