Spinal cord stimulation — a long-term evaluation in patients with chronic pain

Spinal cord stimulation (SCS) is an established treatment modality for chronic pain, angina pectoris, and peripheral vascular disease. This study evaluates experience with SCS over a 13-year period with emphasis on surgical complications, revisions and pain relief. It took the form of a retrospectiv...

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Bibliographic Details
Published in:British journal of neurosurgery 2001-08, Vol.15 (4), p.335-341
Main Authors: KAY, A. D, MCINTYRE, M. D, MACRAE, W. A, VARMA, T. R. K
Format: Article
Language:English
Subjects:
Adult
Aged
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Biological and medical sciences
Chronic Disease
Chronic Pain Neurostimulation Spinal Cord Stimulation
Device Removal
Electric Stimulation Therapy - adverse effects
Electric Stimulation Therapy - methods
Electrodes, Implanted
Female
Humans
Male
Medical sciences
Middle Aged
Nervous system (semeiology, syndromes)
Nervous system as a whole
Neurology
Pain - etiology
Pain Management
Reoperation
Retrospective Studies
Spinal Cord
Surgery
Treatment Outcome
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Summary:Spinal cord stimulation (SCS) is an established treatment modality for chronic pain, angina pectoris, and peripheral vascular disease. This study evaluates experience with SCS over a 13-year period with emphasis on surgical complications, revisions and pain relief. It took the form of a retrospective study of medical/surgical records coupled with a postal/telephone questionnaire. The subjects consisted of seventy patients, aged from 21 to 76 years (mean 47; median 46), with severe, chronic pain refractory to conventional treatment, who underwent SCS implantation between 1984 and 1997. It investigated surgical revisions, complications and pain relief. There were 72 surgical revisions comprising electrode replacement/repositioning (32), generator replacement (22), cable failure (6) and implant removal (12). Half the devices were revised within 3 years (95% confidence interval: 2-5 years) of implantation. Six (8.6%) implants became infected. Sixty percent of patients reported substantial relief of pain. This study shows that the majority of patients undergoing SCS derive significant benefit in terms of pain relief, but commonly require surgical revisions due to both technical and biological factors. These devices require systematic evaluation to determine optimal usage, clinical effectiveness and cost-benefit analysis.
ISSN:0268-8697
1360-046X
DOI:10.1080/02688690120072496