title: Peripheral nerve field stimulation (PNFS) in chronic low back pain: a prospective multicenter study.
abstract: OBJECTIVE
  The goal of this study was to evaluate the long-term efficacy and safety of peripheral nerve field stimulation (PNFS) for chronic low back pain (cLBP).
  
  
  METHODS
  In this prospective, multicenter observational study, 118 patients were admitted to 11 centers throughout Austria and Switzerland. After a screening visit, all patients underwent a trial stimulation period of at least seven days before implantation of the permanent system. Leads were placed in the subcutaneous tissues of the lower back directly in the region of greatest pain. One hundred five patients were implanted with a permanent stimulating system. Patients' evaluation of pain and functional levels were completed before implantation and one, three, and six months after implantation. Adverse events, medication usage, and coverage of the painful area and predictive value of transcutaneous electrical nerve stimulation (TENS) were monitored.
  
  
  RESULTS
  All pain and quality-of-life measures showed statistically significant improvement during the treatment period. These included the average pain visual analog scale, the Oswestry Disability Questionnaire, the Becks Depression Inventory, and the Short Form-12 item Health survey. Additionally, medication usage with opioids, nonsteroidal anti-inflammatory drugs, and anti-convulsants showed a highly significant reduction. Complications requiring surgical intervention were reported in 9.6% of the patients. The degree of coverage of painful areas seems to be an important criterion for efficacy of PNFS, whereas TENS is presumably no predictor.
  
  
  CONCLUSIONS
  This prospective, multicenter study confirms that PNFS is an effective therapy for the management of cLBP. Significant improvements in many aspects of the pain condition were measured, and complications were minimal.
authors: Department of Anaesthesiology, Intensive Care and Pain Medicine, Wilhelminenspital der Stadt Wien, Vienna, Austria.
authors: Herwig
authors: H
authors: Kloimstein
authors: Rudolf
authors: R
authors: Likar
authors: Michael
authors: M
authors: Kern
authors: Josef
authors: J
authors: Neuhold
authors: Miroslav
authors: M
authors: Cada
authors: Nadja
authors: N
authors: Loinig
authors: Wilfried
authors: W
authors: Ilias
authors: Brigitta
authors: B
authors: Freundl
authors: Heinrich
authors: H
authors: Binder
authors: Andreas
authors: A
authors: Wolf
authors: Christian
authors: C
authors: Dorn
authors: Eva Maria
authors: EM
authors: Mozes-Balla
authors: Rolf
authors: R
authors: Stein
authors: Ivo
authors: I
authors: Lappe
authors: Sabine
authors: S
authors: Sator-Katzenschlager
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D010147:Pain Measurement / Q000379:methods*; D011446:Prospective Studies; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D016896:Treatment Outcome
keywords: Chronic pain; low back pain; nonmalignant pain; peripheral nerve stimulation; prospective nonrandomized study