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October 15, 2012
8:00:00 AM - 11:00:00 AM
Room Hall C-Area A
Spinal Cord Stimulator Benefiting Patients With Failed Back Surgery Syndrome: A Retrospective Study
Jyoti Dangle, M.D., Bakul Dave, M.D.
Washington University of Saint Louis, St Louis, Missouri, United States
Background and Aims: Spinal cord stimulator (SCS) has demonstrated success in reducing the pain in patients with chronic neuropathic pain of the lower extremities. Studies have shown that SCS is also very effective in patients with “Failed Back Surgery Syndrome” (FBSS). We evaluated the application of this modality as a definitive treatment option for patients with diverse clinical conditions with the objective to assess its efficacy and the functional outcome.

Methods: A retrospective chart review of 109 patients who received SCS implant by a single pain management specialist over 10 years was performed. Data was collected and analyzed for demographics, initial nature, site and intensity of pain (VAS scores), interference of activities of daily living (ADL’s), previous treatment modalities, medication use and work status prior to the intervention. Patients were followed at 6 and 12 months to assess the pain scores, medication use, work status, improvement in sleep and ADL’s, and adverse events.

Results: Of 109 patients, 72 had FBSS, 6 had CRPS I( Complex Regional Pain Syndrome), 16 had CRPS II, and 15 patients had low back pain with or without radiculopathy. Patients showed significant pain relief at 6 and 12 months (p < 0.001). Our retrospective study has shown that patients in the FBSS category had equivalent pain relief at 6 and 12 months as compared to other patients in the neuropathic pain group. All patients showed reduction in opiod use after SCS but there was no difference in reduction of medication use between the groups. The significant pain relief did not lead to significant increase in the percentage of people working after SCS (26.6 % vs. 28.4%) but of the working group 93% (27/29) continued to work at end of 12 months. Of the adverse events only 2 patients (1.8 %) had serious event like infection, 25 patients (22.8 %) had battery issues and 19 patients (17.4%) required revision.

Conclusion: In our patient subgroup, SCS was an effective pain relief modality in patients with FBSS and had comparable pain relief and reduction in medication use when compared to patients with SCS implanted for CRPS or other neuropathic pain of the lower extremity.

Copyright © 2012 American Society of Anesthesiologists