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  4. Treatment of at-level spinal cord injury pain with botulinum toxin A

Treatment of at-level spinal cord injury pain with botulinum toxin A

Spinal Cord Series and Cases, 2019 · DOI: https://doi.org/10.1038/s41394-019-0221-9 · Published: September 1, 2019

Spinal Cord InjuryPharmacologyPain Management

Simple Explanation

This study investigates whether botulinum toxin A (BoNTA) injections can help reduce pain experienced at the level of spinal cord injury (SCI). This type of pain is often difficult to treat. Participants received either BoNTA or a placebo, and their pain levels were monitored. After a period, those who received the placebo then received BoNTA, and vice versa, to compare the effects. While the study's results didn't reach statistical significance, some participants reported reduced pain and improved quality of life after receiving BoNTA injections, suggesting it might be a potential treatment worth further investigation.

Study Duration
Not specified
Participants
8 participants with traumatic, T1-L3 level, complete SCI
Evidence Level
Level II: Randomized, double-blinded, placebo-controlled, cross-over study

Key Findings

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    A higher proportion of participants reported a marked change in average pain intensity from baseline to 8 and 12 weeks post-BoNTA vs. post-placebo (33% vs. 0%).
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    At 2 and 4 weeks post-BoNTA, almost all participants reported some degree of reduced pain, while the same was not seen post-placebo (83% vs. 0%).
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    More participants reported at least moderate improvements in QOL post-BoNTA vs. post-placebo at 2 (33% vs. 0%) and 4 (33% vs. 0%), 8 (17% vs. 0%), and 12 (33% vs. 0%) weeks

Research Summary

This randomized, double-blinded, placebo-controlled, crossover study explored the effectiveness of botulinum toxin A (BoNTA) for treating at-level spinal cord injury (SCI) pain. Although the data did not meet statistical significance, there was a trend towards improved pain, activities, mood, and sleep among participants after BoNTA injections compared to placebo. The study suggests that subcutaneous injection of BoNTA may be a feasible approach for controlling at-level SCI pain and warrants further investigation despite limitations in sample size and statistical power.

Practical Implications

Potential Therapeutic Option

BoNTA injections may offer a potential treatment option for individuals experiencing at-level SCI pain, which is often resistant to conventional therapies.

Improved Quality of Life

The study suggests that BoNTA may improve the quality of life for individuals with at-level SCI pain by reducing pain and improving activities, mood, and sleep.

Further Research Needed

Larger, statistically powered studies are needed to confirm the efficacy of BoNTA for at-level SCI pain and to determine optimal injection protocols.

Study Limitations

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