Spinal cord stimulation in 112 patients with epi-/intradural fibrosis following operation for lumbar disc herniation.
A total of 112 patients with epi-/intradural fibrosis following operation for lumbar disc herniation were treated by spinal cord stimulation. Lumbosacral spinal fibrosis is seen particularly often after extensive and repeated operations. Radicular pain responds better to stimulation than back pain. A favourable long-term effect on radicular pain has been observed in 67% of patients treated by epidural implantation, the corresponding average follow-up period being 4 1/2 years. 40% of these patients needed less analgesics after the operation, while 25% of them showed an improved fitness for work. Among about 5,000 patients who underwent surgical treatment for lumbar disc herniation, an indication for spinal cord stimulation was found in 1.5%. By comparison, the frequency of the "last resort" procedure of microsurgical cordotomy was 0.3%. We no longer use other ablative methods like extirpation of spinal ganglia.
Probst
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Neurosurgical Clinic, Kantonsspital, Aarau, Switzerland.
D015360:Analgesia, Epidural / Q000379:methods; D001416:Back Pain / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D004824:Epidural Space; D005260:Female; D005355:Fibrosis; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D011843:Radiculopathy / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D012086:Reoperation; D013116:Spinal Cord / Q000473:pathology / Q000503:physiopathology*