title: Persistent pain following lumbar disc replacement.
abstract: BACKGROUND
  Pain patterns associated with the facet and sacroiliac joints following lumbar total disc replacement correlate with biomechanical modeling observations, such as load transfer to the posterior spinal elements in total disc replacement with an artificial disc. When conventional treatment options are exhausted, spinal cord stimulation (SCS) offers clinically favorable outcomes to treat intractable pain.
  
  
  OBJECTIVE
  To contribute to the literature on neuroaugmentive techniques and on pain following disc replacement, and to highlight recent advances and forward-thinking concepts for nonsurgical intradiscal therapies.
  
  
  RESULTS
  Three years of injection therapies and physical therapy did not significantly alleviate the patient's pain. A trial period of SCS rather than reoperation (fusion surgery) was elected. A constant-current multiple source SCS system was implanted. At 12-month follow-up for this system, the patient's pain had been reduced by more than 75%, and the patient reported improved quality of life, including a return of restful sleep.
  
  
  CONCLUSIONS
  SCS is a viable technique to control pain associated with artificial disc implant.
authors.affiliation: Orthopaedic & Spine Center in Columbus, Ohio, USA.
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Wininger
authors.forename: Kedar K
authors.initials: KK
authors.lastname: Deshpande
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Bester
mesh_terms: D000328:Adult; D002908:Chronic Disease; D059350:Chronic Pain / Q000209:etiology* / Q000517:prevention & control*; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000209:etiology* / Q000517:prevention & control*; D009407:Nerve Block; D010147:Pain Measurement; D011843:Radiculopathy / Q000209:etiology / Q000517:prevention & control*; D059145:Total Disc Replacement / Q000009:adverse effects*; D017211:Treatment Failure; D016896:Treatment Outcome