[Spinal cord stimulation (SCS) using an 8-pole electrode and double-electrode system as minimally invasive therapy of the post-discotomy and post-fusion syndrome--prospective study results in 34 patients].
OBJECTIVE
Therapy of a pronounced post-discotomy (PDS) and post-fusion syndrome (PFS) is often unsatisfactory because of the complexity and multifactorial pain genesis. If surgical interventions cannot promise relief and if the entire interdisciplinary spectrum of conservative treatment measures is inadequate, the area of neuromodulative procedures offers spinal cord stimulation (SCS). The objective of this study was to examine the therapeutic possibilities of SCS using an 8-pole electrode and double electrode system in PDS and PFS with extensive back-leg pain areas.


METHODS
An appropriate SCS system was implanted in 34 patients with PDS and PFS. Follow-up examinations were made prospectively over a period of 24 months using general criteria and psychometric test measuring instruments validated for German-language use.


RESULTS
An 8-pole double electrode system was implanted 23 times, a single electrode sufficed in 11 cases. The area of pain was covered in all patients. This required special technical capabilities of the SCS system. The results remained constant over 24 months. The morphine dose could be reduced by at least 50 %. All measuring instruments confirmed a clear reduction in pain and improvement in quality of life as a result of SCS implantation.


CONCLUSIONS
The SCS is an minimally invasive surgical procedure which can enlarge the therapeutical possibilities of pronounced PDS and PFS resistant to other modes of treatment. Special technical possibilities of parameter setting are required to cover the pain areas.
Rütten
S
S
Klinik für Orthopädie am Lehrstuhl für Radiologie und Mikrotherapie, Universität Witten/Herdecke, Ressort Wirbelsäulenchirurgie und Schmerztherapie, St.-Anna-Hospital Herne, Deutschland, Germany. ruetten@orthopain.de
Komp
M
M
Godolias
G
G
D000328:Adult; D002908:Chronic Disease; D017586:Diskectomy; D004599:Electric Stimulation Therapy / Q000295:instrumentation*; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology / Q000628:therapy*; D011183:Postoperative Complications / Q000503:physiopathology / Q000628:therapy*; D019736:Prostheses and Implants; D013116:Spinal Cord / Q000503:physiopathology*; D013123:Spinal Fusion