Incidence and predictive factors of spinal cord stimulation treatment after lumbar spine surgery
Vakkala, Merja; Järvimäki, Voitto; Kautiainen, Hannu; Haanpää, Maija; Alahuhta, Seppo (2017-10-05)
Vakkala, M., Järvimäki, V., Kautiainen, H., Haanpää, M., Alahuhta, S. (2017) Incidence and predictive factors of spinal cord stimulation treatment after lumbar spine surgery. Journal of Pain Research, Volume 10 (), 2405-2411. doi:10.2147/JPR.S143633
© 2017 Vakkala et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
Introduction: Spinal cord stimulation (SCS) is recommended for the treatment of postsurgical chronic back and leg pain refractory to other treatments. We wanted to estimate the incidence and predictive factors of SCS treatment in our lumbar surgery cohort.
Patients and methods: Three questionnaires (a self-made questionnaire, the Oswestry Low Back Pain Disability Questionnaire, and the Beck Depression Inventory) were sent to patients aged 18–65 years with no contraindications for the use of SCS, and who had undergone non-traumatic lumbar spine surgery in the Oulu University Hospital between June 2005 and May 2008. Patients who had a daily pain intensity of ≥5/10 with predominant radicular component were interviewed by telephone.
Results: After exclusions, 814 patients remained in this cohort. Of those, 21 patients had received SCS by the end of June 2015. Fifteen (71%) of these received benefit and continued with the treatment. Complications were rare. The number of patients who replied to the postal survey were 537 (66%). Eleven of them had undergone SCS treatment after their reply. Features predicting SCS implantation were daily or continuous pain, higher intensities of pain with predominant radicular pain, more severe pain-related functional disability, a higher prevalence of depressive symptoms, and reduced benefit from pain medication. The mean waiting time was 65 months (26–93 months). One hundred patients were interviewed by telephone. Fourteen seemed to be potential SCS candidates. From the eleven patients who underwent SCS after responding to the survey, two were classified as potential candidates in the phone interview, while nine were other patients. Twelve patients are still waiting for treatment to commence.
Conclusion: In our region, the SCS treatment is used only for very serious pain conditions. Waiting time is too long and it may be the reason why this treatment option is not offered to all candidates.
- Avoin saatavuus