Spinal cord stimulation: a valuable treatment for chronic failed back surgery patients.
Spinal cord stimulation (SCS) has been used in the treatment of "chronic failed back surgery syndrome" for many years. To evaluate long-term results and cost effectiveness of SCS, we interviewed 69 patients treated during a period of 13 years. Twenty-six patients stopped using SCS; there was no clear explanation for this unsatisfactory result in 10. Forty-three patients continued with the therapy and obtained good pain relief. Electrode breakage either spontaneous or due to a procedure to obtain better stimulation paresthesias was more frequent in the radiofrequency-coupled system group than in the battery group (mean +/- SEM 2.81 +/- 2.0 versus 1.42 +/- 1.51, respectively; P = 0.0018). Ten patients obtained better pain relief than during the trial procedure. Some still need opioid analgesics, but 11 of the 16 who require these drugs obtained a synergistic effect when concomitantly using the stimulator. Eleven patients have returned to work. In our center, the application of SCS costs on average $3660 per patient per year. Although this seems expensive, it may be a cost-effective treatment if other therapies fail.
Devulder
J
J
Department of Anesthesia-Section Pain Clinic, University Hospital of Gent, Belgium.
De Laat
M
M
Van Bastelaere
M
M
Rolly
G
G
D000328:Adult; D001416:Back Pain / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy*; D002908:Chronic Disease; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019233:Retreatment; D013116:Spinal Cord / Q000503:physiopathology*; D013577:Syndrome; D017211:Treatment Failure