Failed back surgery syndrome; Follow-up studies; Patient outcome assessment; Spinal cord stimulation; Analgesics; Analgesics/therapeutic use; Failed Back Surgery Syndrome/physiopathology; Failed Back Surgery Syndrome/therapy; Female; Follow-Up Studies; Humans; Male; Middle Aged; Pain Measurement; Patient Outcome Assessment; Prospective Studies; Spinal Cord Stimulation/methods; Treatment Outcome; Activities of Daily Living; Sleep; Surgery; Neurology (clinical)
Abstract :
[en] OBJECTIVE: The use of multicolumn-lead spinal cord stimulation (SCS) to control back pain (BP) and leg pain (LP) in patients with failed back surgery syndrome (FBSS) in the short term and mid-term has been well documented. Our study investigated whether SCS remained efficient after 72 months.
METHODS: In an observational, single-center study, we assessed SCS efficacy in 62 patients with FBSS patients. BP, LP, and magnitude of daily activity limitation (DAL) were graded using a 0-10 visual analog scale (VAS) preoperatively and at 2, 6, 12, 24, 36, and 72 months after SCS implantation. Sleep quality, use of medications, and complications were also recorded.
RESULTS: Of the 62 patients, 15 with complete follow-up data available were still using their SCS device at 72 months (SCS+). For these patients, the VAS scores for BP, LP, and DAL had changed from a median of 9 (interquartile range [IQR], 8.5-10), 7 (IQR, 6-8), and 8 (IQR, 8-9) preoperatively to a median of 4 (IQR, 3-4.5), 3 (IQR, 1.5-3.5), and 3 (IQR, 2-4) at 72 months. Their quality of sleep and analgesic medication consumption had also improved. In a subset of patients no longer using the SCS device after 72 months (SCS-), the VAS scores for BP, LP, and DAL, quality of sleep, and medication consumption were comparable to those for the SCS+ group. The SCS- group was less satisfied with the technique and were less professionally active than were the SCS+ group.
CONCLUSIONS: The SCS device provides sustained beneficial effects on BP, LP, DAL, sleep, and medication consumption in patients with FBSS still using it at 72 months postoperatively. Further studies are needed to identify the factors of adherence to the technique and the chances of success compared with the natural evolution of FBSS.
Disciplines :
Anesthesia & intensive care
Author, co-author :
Remacle, Thibault ; Department of Neurosurgery, Regional Hospital Center Citadelle, Liege, Belgium, Department of Neurosurgery, University Hospital Center Liege, Liege, Belgium.
Mauviel, Stephane; Department of Algology, Regional Hospital Center Citadelle, Liege, Belgium
Renwart, Henri-Jean; Department of Neurosurgery, Regional Hospital Center Citadelle, Liege, Belgium
Ghassempour, Keyvan; Department of Neurosurgery, Regional Hospital Center Citadelle, Liege, Belgium
Belle, Frederic; Department of Neurosurgery, Regional Hospital Center Citadelle, Liege, Belgium
Lückers, Olivier; Department of Neurosurgery, Regional Hospital Center Citadelle, Liege, Belgium
Bex, Vincent; Department of Neurosurgery, Regional Hospital Center Citadelle, Liege, Belgium
Remacle, Jean-Michel; Department of Neurosurgery, Regional Hospital Center Citadelle, Liege, Belgium
Bonhomme, Vincent ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'anesthésie - réanimation
Language :
English
Title :
Long-Term Multicolumn-Lead Spinal Cord Stimulation Efficacy in Patients with Failed Back Surgery Syndrome: A Six-Year Prospective Follow-up Study.
Conflict of interest statement: The present study was supported by the Department of Neurosurgery, CHR Citadelle, Liege, Belgium. Jean-Michel Remacle has received financial support for other research from Medtronic and Depuy Synthes; Vincent Bonhomme has received financial and technical help for other research from Orion Pharma and Metrodoloris and honoraria for consultancy from Medtronic.Conflict of interest statement: The present study was supported by the Department of Neurosurgery, CHR Citadelle, Liege, Belgium. Jean-Michel Remacle has received financial support for other research from Medtronic and Depuy Synthes; Vincent Bonhomme has received financial and technical help for other research from Orion Pharma and Metrodoloris and honoraria for consultancy from Medtronic.
Harvey, A.M., Classification of chronic pain—descriptions of chronic pain syndromes and definitions of pain terms. Clin J Pain, 11, 1995, 163.
Iorio, J.A., Jakoi, A.M., Singla, A., Biomechanics of degenerative spinal disorders. Asian Spine J 10 (2016), 377–384.
Hoy, D., Brooks, P., Blyth, F., Buchbinder, R., The epidemiology of low back pain. Best Pract Res Clin Rheumatol 24 (2010), 769–781.
Sebaaly, A., Lahoud, M.J., Rizkallah, M., Kreichati, G., Kharrat, K., Etiology, evaluation, and treatment of failed back surgery syndrome. Asian Spine J 12 (2018), 574–585.
Parker, S.L., Mendenhall, S.K., Godil, S.S., et al. Incidence of low back pain after lumbar discectomy for herniated disc and its effect on patient-reported outcomes. Clin Orthop Relat Res 473 (2015), 1988–1999.
Skolasky, R.L., Wegener, S.T., Maggard, A.M., Riley, L.H., The impact of reduction of pain after lumbar spine surgery: the relationship between changes in pain and physical function and disability. Spine (Phila Pa 1976) 39 (2014), 1426–1432.
White, P.F., An alternative approach to solving the opioid epidemic: is there a role for non-pharmacologic analgesic therapies?. Postgrad Med 131 (2019), 1–5.
Deer, T.R., Grider, J.S., Lamer, T.J., et al. A systematic literature review of spine neurostimulation therapies for the treatment of pain. Pain Med 21 (2020), 1421–1432.
Remacle, T.Y., Bonhomme, V.L., Renwart, H.-J.P., Remacle, J.M., Effect of multicolumn lead spinal cord stimulation on low back pain in failed back surgery patients: a three-year follow-up. Neuromodulation 20 (2017), 668–674.
Waszak, P.M., Modrić, M., Paturej, A., et al. Spinal cord stimulation in failed back surgery syndrome: review of clinical use, quality of life and cost-effectiveness. Asian Spine J 10 (2016), 1195–1204.
Rigoard, P., Desai, M.J., Taylor, R.S., Failed back surgery syndrome: what's in a name? A proposal to replace “FBSS” by “POPS.”. Neurochirurgie 61:suppl 1 (2015), S16–S21.
Cho, J.H., Lee, J.H., Song, K.S., et al. Treatment outcomes for patients with failed back surgery. Pain Physician 20 (2017), E29–E43.
Amirdelfan, K., Webster, L., Poree, L., Sukul, V., McRoberts, P., Treatment options for failed back surgery syndrome patients with refractory chronic pain: an evidence based approach. Spine (Phila Pa 1976) 42:suppl 14 (2017), S41–S52.
North, R.B., Kumar, K., Wallace, M.S., et al. Spinal cord stimulation versus re-operation in patients with failed back surgery syndrome: an international multicenter randomized controlled trial (EVIDENCE study). Neuromodulation 14 (2011), 330–335 [discussion: 335-336].
Rigoard, P., Desai, M.J., North, R.B., et al. Spinal cord stimulation for predominant low back pain in failed back surgery syndrome: study protocol for an international multicenter randomized controlled trial (PROMISE study). Trials, 14, 2013, 376.
Kapural, L., Yu, C., Doust, M.W., et al. Comparison of 10-kHz high-frequency and traditional low-frequency spinal cord stimulation for the treatment of chronic back and leg pain: 24-month results from a multicenter, randomized, controlled pivotal trial. Neurosurgery 79 (2016), 667–677.
Kumar, K., Taylor, R.S., Jacques, L., et al. The effects of spinal cord stimulation in neuropathic pain are sustained: a 24-month follow-up of the prospective randomized controlled multicenter trial of the effectiveness of spinal cord stimulation. Neurosurgery 63 (2008), 762–770.
Manca, A., Kumar, K., Taylor, R., et al. Quality of life, resource consumption and costs of spinal cord stimulation versus conventional medical management in neuropathic pain patients with failed back surgery syndrome (PROCESS trial). Eur J Pain 12 (2008), 1047–1058.
Kumar, K., Rizvi, S., Cost-effectiveness of spinal cord stimulation therapy in management of chronic pain. Pain Med 14 (2013), 1631–1649.
Grider, J., Manchikanti, L., Carayannopoulos, A., et al. Effectiveness of spinal cord stimulation in chronic spinal pain: a systematic review. Pain Physician 19 (2016), E33–E54.
Odonkor, C., Kwak, R., Ting, K., Hao, D., Collins, B., Ahmed, S., Fantastic four: age, spinal cord stimulator waveform, pain localization and history of spine surgery influence the odds of successful spinal cord stimulator trial. Pain Physician 23 (2020), E19–E30.
Son, B.C., Kim, D.R., Lee, S.W., Chough, C.K., Factors associated with the success of trial spinal cord stimulation in patients with chronic pain from failed back surgery syndrome. J Korean Neurosurg Soc 54 (2013), 501–506.
Jang, H.-D., Kim, M.-S., Chang, C.-H., Kim, S.-W., Kim, O.-L., Kim, S.-H., Analysis of failed spinal cord stimulation trials in the treatment of intractable chronic pain. J Korean Neurosurg Soc 3 (2008), 85–89.
White, P.F., An alternative approach to solving the opioid epidemic: expanding the use of non-pharmacologic techniques for acute and chronic pain management. J Mol Biol Methods, 1, 2018, 1.
LeDoux, M., Langford, K., Spinal cord stimulation for the failed back syndrome. Spine (Phila Pa 1976) 18 (1993), 191–194.
Chincholkar, M., Eldabe, S., Strachan, R., et al. Prospective analysis of the trial period for spinal cord stimulation treatment for chronic pain. Neuromodulation 14 (2011), 523–528 [discussion: 528-529].
