Appareil locomoteur SOFMER/ SOFCOT

Le 02/12/2022 de 08:00 à 09:30

Retour Session


Etude prospective de suivi de cas précoces de syndrome douloureux régional complexe (CRPS) : évolution du CSS ( CRPS Severity Score)

Soisic Lecroc (Sion, Suisse), Philippe Vuistiner (sion, Suisse), Bertrand Léger (sion, Suisse), Konzelmann Michel (Sion, Suisse), François Luthi (Sion, Suisse)

Objective : The Complex Regional Pain Syndrome (CRPS) Severity Score (CSS) was proposed to allow a more precise follow-up of patients than the Budapest criteria alone. The objective of this study was to measure the evolution of the CSS of early CRPS patients with a follow-up of at least 1 year.

Material / Patients and Methods : Prospective study including CRPS patients (<6 months). Use of the Budapest criteria, CSS (sum of 8 symptoms and 8 signs from the Budapest criteria), DN4, and Brief Pain Inventory.

Results : 69 patients were included, 39 with a 1-year follow-up. The mean time from initial trauma to inclusion was 116 days, and 87 days from symptoms suggestive of CRPS to inclusion.
At inclusion, mean CSS was 11.3 (±2.0) (range 0-16), pain severity 4.7 (±2.1), DN4 score:  4.3 (±2.7).
At 3 months, mean CSS was 8.3 (± 3.3).
At 12 months, mean CSS was 5.1 (±3.3), with 67% of patients showing a decrease of at least 4.9, considered as the smallest clinically important difference. DN4 was 2.5 (±2.2). Reduction in CSS was associated with reduction in DN4 (r=0.49). Higher CSS score at T0 was related to higher CSS reduction at T12 (r=0.41).

Discussion - Conclusion : This study confirms the importance of the CSS for the follow-up of CRPS patients. Our results are comparable to those of Harden from the original study on new CRPS regarding the reduction of the CSS score at 3 months. This study also shows a decrease of the CSS score beyond 3 months resulting in an increase of patients with clinically significant improvement.

Keywords : Complex Regional Pain Syndrome (CRPS), CRPS Severity Score (CSS)