Is the Spinal Cord Stimulation an effective treatment for Failed Back Surgery Syndrome? – Our experience with 21 cases

Ali je stimulacija hrbtenjače učinkovita metoda zdravljenja vztrajajoče bolečine v križu in nogi po operaciji? – Naše izkušnje z 21 primeri

Abstract

Purpose: Management of failed back surgery syndrome (FBSS) is a costly challenge for practitioners of multidisciplinary pain management and for clinicians offering medical, surgical or behavioural therapy. We analyzed the outcome of FBSS treatment with the spinal cord stimulation (SCS).

Methods: A retrospective analysis involved 21 patients (10 men and 11 women, median age 50 years) suffering from FBSS. They were treated with the SCS over a 5–year period at the Department of Neurosurgery, University Clinical Centre Maribor. Their pain intensity, clinical alteration in pain relief, functional disability, employment status, analgesics consumption and complications were evaluated.

Result: The median follow–up after the SCS was 24 months. According to Visual Analogue Scale (VAS) measurement, pain intensity before the SCS was scored between 7 and 10, median value 8. After the SCS, the VAS scores ranged between 3 and 6, median value 4 (p<0.0001). A reduction in postoperative drug consumption was evident. All employed patients returned to work. Results of functional disability measured according to Oswestry Disability Index (ODI) ranged from 18% to 78% with the mean value of 39% (moderate disability).

Conclusion: The SCS is a treatment of choice for patients with FBSS–associated chronic leg pain, where the pain persists in spite of the optimized conventional pain treatment. It improves the quality of life, reduces drug consumption and enables patients to return to work.