title: Spinal Cord Stimulation: An Alternative Concept of Rehabilitation?
abstract: Chronic low back and leg pain is a disabling condition, affecting, in most cases, older patients with congenital or acquired spinal stenosis or patients with failed back surgery syndrome. Spinal cord stimulation has been introduced as an effective therapeutic option for those patients who have previously been operated without significant clinical benefits, or for all those patients who are ineligible for traditional surgery.
  
  
  
  We report our experience with ten patients treated with spinal cord stimulation plus medication and physical therapy between November 2014 and September 2015. Inclusion criteria were: previous surgical treatments for lumbar stenosis and metameric instability and persistent or ingravescent disabling low back and leg pain, with a mean duration of symptoms of at least 18 months. A visual analog scale (VAS) was employed for back and leg pain, and the Oswestry Disability Index (ODI) score was determined, and findings were analyzed after 6 months.
  
  
  
  No intra- or postoperative complication was recorded. The mean VAS score for back pain decreased from 7.5 to 2.9, while leg VAS decreased from 8.2 to 3.0. Analysis of ODI values showed evident improvement in daily life activities, ranging from a median value of 75.7% to 32.7 % after the stimulation.
  
  
  
  Spinal cord stimulation has a recognized impact on the pain and on the quality of life of patients with failed back surgery syndrome.
authors.affiliation: Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Neurosurgical Clinic, University of Palermo, Via del Vespro 129, Palermo, 90100, Italy. alfagamma82@libero.it.
authors.forename: Antonella
authors.initials: A
authors.lastname: Giugno
authors.affiliation: Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Neurosurgical Clinic, University of Palermo, Via del Vespro 129, Palermo, 90100, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Gulì
authors.affiliation: Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Neurosurgical Clinic, University of Palermo, Via del Vespro 129, Palermo, 90100, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Basile
authors.affiliation: Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Neurosurgical Clinic, University of Palermo, Via del Vespro 129, Palermo, 90100, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Graziano
authors.affiliation: Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Neurosurgical Clinic, University of Palermo, Via del Vespro 129, Palermo, 90100, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Maugeri
authors.affiliation: Institute of Neurosurgery, Medical School, Catholic University of Rome, Rome, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Visocchi
authors.affiliation: Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Neurosurgical Clinic, University of Palermo, Via del Vespro 129, Palermo, 90100, Italy.
authors.forename: Domenico Gerardo
authors.initials: DG
authors.lastname: Iacopino
mesh_terms: D000368:Aged; D001174:Arthrodesis; D001416:Back Pain / Q000534:rehabilitation; D019299:Decompression, Surgical; D055111:Failed Back Surgery Syndrome / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D062187:Spinal Cord Stimulation / Q000379:methods*; D013130:Spinal Stenosis / Q000534:rehabilitation* / Q000601:surgery
keywords: Chronic low back pain; Failed back surgery syndrome; Spinal cord stimulation