title: Spinal cord stimulation for FBSS and CRPS: A review of 80 cases with on-table trial of stimulation.
abstract: BACKGROUND
  Spinal cord stimulation (SCS) is used for the treatment of chronic neuropathic pain, a notoriously difficult condition to treat. Failed Back Surgery Syndrome (FBSS) and Complex Regional Pain syndrome (CRPS) remain the strongest indications. Funding remains a difficult issue and the use of trial of stimulation is the traditional method of ensuring best outcomes from implantation.
  
  
  METHODS
  A retrospective and consecutive review of 80 cases of spinal cord stimulation for patients with a diagnosis of FBSS and CRPS having undergone prior comprehensive medical management and interventional treatment with no sustained benefit. Trial of stimulation was performed on-table and if acceptable coverage was achieved, the case proceeded to full implantation.
  
  
  RESULTS
  The mean patient age was 50.08 years (range 28-80 years). At 12 months follow-up, thirty two patients (40%) no longer required analgesic medication. Thirty patients (37.5%) reported their pain was manageable with first line analgesics. Fourteen (17.5%) reported their pain was manageable first line analgesic and occasional tramadol or codeine. Four (5%) reported that their pain was manageable with NSAID's, paracetamol, amitriptyline, and regular codeine or tramadol. Seventeen out of eighty patients (21.25%) were unemployed before SCS implant, and at 12 months follow up eight of these patients (47.05%) had returned to work. There was no infective complications or explants. Two patients (2.53%) required one lead revision, which was successful.
  
  
  CONCLUSIONS
  SCS is the most effective treatment for FBSS and CRPS, which is proven resistant to medical management. On-table trial and implantation is easy to perform with good success rate and low morbidity and if successful will reduce complication rates, especially infection.
authors.forename: Hari
authors.initials: H
authors.lastname: Gopal
authors.forename: Joseph
authors.initials: J
authors.lastname: Fitzgerald
authors.forename: Connail
authors.initials: C
authors.lastname: McCrory
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D020918:Complex Regional Pain Syndromes / Q000628:therapy*; D055111:Failed Back Surgery Syndrome / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D062707:Return to Work / Q000706:statistics & numerical data; D062187:Spinal Cord Stimulation
chemical_list: D000700:Analgesics
keywords: CRPS; FBSS; spinal cord stimulation