Intrathecal drug delivery for treatment of chronic low back pain: report from the National Outcomes Registry for Low Back Pain.
OBJECTIVE
To obtain data on patient demographics, clinical practices, and long-term outcomes for patients with chronic low back pain treated with implantable drug-delivery systems.


METHODS
The National Outcomes Registry for Low Back Pain collected data at baseline, trialing, implant (or decision not to implant), and at 6- and 12-month follow-ups. Data were collected at all time points, regardless of implant status.


METHODS
Numeric pain ratings and Oswestry Low Back Pain Disability scores from implanted patients were compared among baseline and 6- and 12-month follow-ups. Patients were also asked to rate their quality of life and satisfaction with the therapy.


RESULTS
Thirty-six physicians enrolled 166 patients to be trialed for drug-delivery systems. The trialing success rate was 93% (154 patients). In all, 136 patients (82%) were implanted. In the implant group, numeric pain ratings dropped by more than 47% for back pain and more than 31% for leg pain at the 12-month follow-up. More than 65% of implanted patients reduced their Oswestry scores by at least one level at their 12-month follow-ups compared with baseline. At 12-month follow-ups, 80% of implanted patients were satisfied with their therapy and 87% said they would undergo the procedure again.


CONCLUSIONS
Current clinical practices related to trialing of drug-delivery systems resulted in the majority of patients successfully trialed. At 12-month follow-ups, implanted patients experienced reductions in numeric back and leg pain ratings, improved Oswestry scores, and high satisfaction with the therapy.
Center for Pain Relief, Charleston, West Virginia 25301, USA. doctdeer@aol.com
Timothy
T
Deer
Iva
I
Chapple
Ashley
A
Classen
Keith
K
Javery
Valerie
V
Stoker
Lisa
L
Tonder
Kim
K
Burchiel
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D002908:Chronic Disease; D016503:Drug Delivery Systems / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D017116:Low Back Pain / Q000188:drug therapy* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000187:drug effects / Q000523:psychology; D017060:Patient Satisfaction; D012042:Registries; D016896:Treatment Outcome
D000701:Analgesics, Opioid