infusion of drugs and pulsed radiofrequency treatmentin radicular pain.

Objective. to compare the effectiveness of epiduraladhesiolysis and PRF with Pasha Cath versus adhesiol-ysis with Racz catheter.

Design. Prospective open-label randomized trialSetting. Department of Pain Medicine, Private Hos-

pital, Forlı̀, Italy.Inclusion criteria. All patients affected by sensitive

lumbar monolateral mono or bi-radiculopathy for morethan 6 months, with pathogenetic diagnosis of perifericneuropathic pain.

Interventions. All patients were randomized toundergo epidural adhesiolysis and PRF with Pasha Cathand adhesiolysis with Racz catheter.

Effectiveness assessments. NRS (resting/incident)Oswestry Disability Questionnaire, QUID test (ItalianPain Questionary) at baseline, first and third month.

Results. Follow-up in progress.

doi:10.1016/j.ejpain.2007.03.445

431SPINAL CORD STIMULATION IN ALLODYNIC

SPINAL CORD INJURY (SCI) PAIN

L. Sitzmann *, B. Silhouette, A. Margot-Duclot, H.

Andrianasolo, J.B. Thiebaut

Neurochirurgie-UTD, Fondation Rothschild, Paris,

France

Below level pain in SCI are challenging as there arefew treatments shown to be effective. Particularly theresults of spinal cord stimulation are generally consid-ered to be very disappointing. We looked if we coulddefine a subgroup of patients who may benefit from thistreatment.

Study. This prospective study included patients withallodynic unilateral below level pain. Clinical examina-tion showed a lesion of the spino-thalamic pathway.The lemniscal pathways are relatively preserved, provedby somato-sensory evoked potentials.

If the pain evaluation requirements were satisfied,patients were included and a percutaneous spinal cordstimulation test was performed.

Results. We included six patients between 2001 and2006. Four patients improved more than 60% and thesystem was definitively implanted. The long term results(1–6 years) are presented. Good results (more than 50%relief) remained.

Discussion. The crucial point is the selection ofpatients.

We discuss:

– the pain assessment

– the type of the lesion: the preservation of the lemnis-cal pathway seems to be deciding;

– the percutanous test for its prognostic interest and asan element of care;

– the technical aspects as the level of stimulation andthe choice of parameters.

Conclusion. This short series and the limited longterm results do not allow to draw definite conclusions.Nevertheless, even a treatment considered as disappoint-ing like spinal cord stimulation in SCI can be of benefitto a subgroup of patients when the indications are spec-ified accurately.

doi:10.1016/j.ejpain.2007.03.446

432CHRONIC MANAGEMENT OF TOTAL

IMPLANTABLE PUMPS FOR PAIN TREATMENT:

REVIEW OF PERSONAL EXPERIENCE AND

OBSERVATIONSN. Stefani *, G. Rea, D. Mangeruga, P.V. Nardi

Neurochirurgia, Policlinico Casilino, Rome, Italy

Background and aims. Neurosurgical treatment ofintractable pain syndromes comprise the possibility toimplant pump delivering pharmacological systems. Wereport our experience in the long term follow up and gen-eral management of total implantable pumps for thedrug delivering in the subarachnoid or epidural space.

Methods. A total number of 64 patients were treatedfrom January 2000 to December 2005. Mean age was of56 years old, female were predominant (68%). Patientswere affected by pain syndromes regarding intractabledeafferentation pain (myelopathies), failed back surgerysyndrome, intractable low back pain and oncologicalpain.

Drugs commonly utilized were morphine, buprenor-phine and tramadolo.

Results. Patients affected from chronic benign pain(56 cases) were treated with tramadolo or low doses ofmorphine or buprenorphine. These patients reached agood response in a percentage variable from 60% to85% of cases and needed frequent dosage variation.

Patients suffering from cancer pain (8 cases) werealmost considered as good responders, they were treatedwith morphine in all cases.

Patients initially treated with tramadolo summinis-tered in the epidural space have had no response forpain control beneath their initial good response to it.All these patients were then treated with buprenorphinewith a good and long standing effect on pain relief.

Poster Presentations / Clinical – Other Treatments / European Journal of Pain 11(S1) (2007) S59–S207 S191