[Efficacy of spinal cord stimulation in the treatment of lower extremity peripheral arterial disease].

Objective: To observe the clinical efficacy of spinal cord stimulation (SCS) in treating lower extremity peripheral arterial disease (PAD). Methods: A retrospective analysis was conducted on the clinical data of patients diagnosed with lower extremity PAD at Nanjing Hospital of Nanjing Medical University from October 2021 to August 2024. Patients were divided into SCS group and control group based on whether they underwent SCS implantation surgery. Propensity score matching (PSM) was applied to match the two groups. The numeric rating scale (NRS) score, Pittsburgh sleep quality index (PSQI), perfusion index (PI), and skin blood flow (SkBF) were recorded at pre-treatment (T0), 7 days (T1), 1 month (T2), 3 months (T3), 6 months (T4), and 1 year (T5) post-treatment, and adverse reactions and complications were also reviewed after treatment. Repeated measures analysis of variance (ANOVA) was used to compare the therapeutic effects between the two groups at different time points before and after treatment. Results: A total of 46 patients were included, with 23 patients in the SCS group [14 males and 9 females, aged (63.3±7.6) years], and 23 patients in the control group [13 males and 10 females, aged (62.0±8.5) years]. There were no statistically significant differences in general clinical characteristics, or in pre-treatment NRS score [(7.9±1.0) vs (8.3±1.0) scores], PSQI [16.4±1.3) vs (16.9±1.2) scores], PI [(0.32±0.12) vs (0.29±0.08)], and SkBF [(28.65±6.39) vs (30.48±4.77) perfusion units] between the SCS group and the control group (all P>0.05). Repeated measures ANOVA showed that at different follow-up time points, the NRS score and PSQI in the SCS group were lower than those in the control group (all Pgroup P<0.05), while the PI and SkBF were higher than those in the control group (all Pgroup P<0.05). Additionally, within the SCS group, post-treatment NRS score and PSQI were lower than those at T0 (all Ptime<0.05), and the PI and SkBF were higher than those at T0 (all Ptime<0.05). None of the patients experienced severe adverse reactions related to SCS, and no deaths occurred. Conclusion: SCS is effective in treating lower extremity PAD, as it can relieve pain, improve sleep quality, and enhance microcirculation.