title: Is spinal cord stimulation an effective treatment option for discogenic pain?
abstract: BACKGROUND
  In a prospective observational study conducted in an urban pain management center, we evaluated whether spinal cord stimulation (SCS) is effective in relieving discogenic pain of IDD origin.
  
  
  METHODS
  Thirteen patients with intractable discogenic low back pain were enrolled. Four patients never underwent permanent implantation due to insurance denial, medical reasons or failed trial and served as a control group. Nine patients underwent SCS implantation (treatment group). All patients were followed for 12 months and assessed at each interval for pain (NRS), disability (ODI), and opioid use.
  
  
  RESULTS
  Nine patients completed the SCS trial with > 50% pain relief. The pretrial NRS score was 7.8 ± 0.5 mm in treated patients vs. 6.5 ± 1.7 mm in control patients. At 3, 6 and 12 months, the NRS was reduced to 2.9 ± 0.7 mm, 1.7 ± 0.5 mm, and 2.9 ± 0.5 mm, respectively in treated patients. NRS was unchanged in the control patients (6.5 ± 1.9 mm). The ODI score prior to the SCS trial in treated patients was 53.1 ± 3.4% vs. 54.0 ± 20.5 in control patients. At 3, 6 and 12 months the ODI scores were 39.0 ± 8.0%, 38.7 ± 4.6%, and 41.1 ± 3.9%, respectively in the treated patients, and 48.5 ± 29.5 at 12 months in control patients. In 6 patients receiving opioids prior to the SCS trial, average consumption was reduced by 69% (P = 0.036) over 12 months of therapy as compared with a 54% increase in the control patients. SCS usage was stable over the 12-month study.
  
  
  CONCLUSIONS
  The current study indicates that SCS may provide effective pain relief, improve disability, and reduce opioid usage in patients with discogenic pain.
authors.affiliation: Pain Medicine Physician, Millennium Pain Center, Bloomington, Illinois 61701, USA. vallejo@millenniumpaincenter.com
authors.forename: Ricardo
authors.initials: R
authors.lastname: Vallejo
authors.forename: L Manuel
authors.initials: LM
authors.lastname: Zevallos
authors.forename: Jessica
authors.initials: J
authors.lastname: Lowe
authors.forename: Ramsin
authors.initials: R
authors.lastname: Benyamin
mesh_terms: D000328:Adult; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology*; D017116:Low Back Pain / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D011446:Prospective Studies; D013116:Spinal Cord; D013122:Spinal Diseases / Q000150:complications; D016896:Treatment Outcome