title: Presurgical Psychological Assessments as Correlates of Effectiveness of Spinal Cord Stimulation for Chronic Pain Reduction.
abstract: BACKGROUND
  Spinal Cord Stimulator (SCS) is a surgically implanted device for patients with certain types of chronic pain. While some studies show the value of psychological screening of potential SCS candidates, no consensus exists. This single-site study analyzed the association of SCS success with psychological assessments (e.g., Millon Behavioral Medicine Diagnostic), beliefs regarding SCS efficacy, self-reported pain and quality of life (QOL) among patients approved for SCS.
  
  
  METHODS
  Potential SCS candidates (N = 200) were contacted 3-7 years after initial psychological and medical clearance for SCS; 59 consented to a structured telephone interview. Thirty-four of the 59 had received a SCS; 25 had not received a SCS. Of the 34 that had received a SCS, 22 were approved by routine psychological evaluation while 12 went through in-depth psychological testing.
  
  
  RESULTS
  The majority of respondents (62%) reported effective pain reduction, and 64% of SCS recipients reported improved QOL. Younger patients reported higher pre-implantation pain scores, and participants with higher levels of pain preimplantation were more likely say they would undergo the procedure again. Finally, persons reporting preoperative alcohol problems were more likely to report lower levels of post-SCS pain.
  
  
  CONCLUSIONS
  Predictors of pain relief and QOL following SCS may depend on expectations of the device and on individuals' interpretation of pain or psychosocial health.
authors.affiliation: Department of Psychiatry, Baylor Scott & White Health, Temple, TX, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Blackburn
authors.affiliation: Department of Psychiatry, Baylor Scott & White Health, Temple, TX, USA.
authors.forename: Cinamon C
authors.initials: CC
authors.lastname: Romers
authors.affiliation: Center for Applied Health Research, Central Texas Veterans Health Care System, Baylor Scott & White Health, Temple, TX, USA.|Texas A&M Health Science Center, College of Medicine, Bryan, TX, USA.|Department of Psychiatry, UT Health Science Center San Antonio, San Antonio, TX, USA.
authors.forename: Laurel A
authors.initials: LA
authors.lastname: Copeland
authors.affiliation: Department of Anesthesiology, Baylor Scott & White Health, Temple, TX, USA.
authors.forename: Windrik
authors.initials: W
authors.lastname: Lynch
authors.affiliation: Department of Anesthesiology, Texas A&M College of Medicine and Health Science Center, Temple, TX, USA.
authors.forename: David D
authors.initials: DD
authors.lastname: Nguyen
authors.affiliation: Center for Applied Health Research, Central Texas Veterans Health Care System, Baylor Scott & White Health, Temple, TX, USA.|Texas A&M Health Science Center, College of Medicine, Bryan, TX, USA.|Department of Psychiatry, UT Health Science Center San Antonio, San Antonio, TX, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Zeber
authors.affiliation: Guidance Department, Flagler County Schools, Flagler County, FL, USA.|Child & Adolescent Development and Child & Adult Behavioral Sleep, Ormand Beach, FL, USA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Hoffman
mesh_terms: D000368:Aged; D059350:Chronic Pain / Q000523:psychology* / Q000628:therapy*; D055111:Failed Back Surgery Syndrome; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D057234:Preoperative Period; D011788:Quality of Life; D012189:Retrospective Studies; D013116:Spinal Cord / Q000502:physiology*; D062187:Spinal Cord Stimulation / Q000379:methods*
keywords: back pain; failed back surgery syndrome; interview; longitudinal studies; postlaminectomy syndrome; prospective studies; psychological; spinal cord stimulation; spinal cord stimulator