Browse > Article
http://dx.doi.org/10.3340/jkns.2013.54.6.501

Factors Associated with the Success of Trial Spinal Cord Stimulation in Patients with Chronic Pain from Failed Back Surgery Syndrome  

Son, Byung-Chul (Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine)
Kim, Deok-Ryeong (Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea College of Medicine)
Lee, Sang-Won (Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea College of Medicine)
Chough, Chung-Kee (Department of Neurosurgery, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine)
Publication Information
Journal of Korean Neurosurgical Society / v.54, no.6, 2013 , pp. 501-506 More about this Journal
Abstract
Objective : Spinal cord stimulation (SCS) is an effective means of treatment of chronic neuropathic pain from failed back surgery syndrome (FBSS). Because the success of trial stimulation is an essential part of SCS, we investigated factors associated with success of trial stimulation. Methods : Successful trial stimulation was possible in 26 of 44 patients (63.6%) who underwent insertion of electrodes for the treatment of chronic pain from FBSS. To investigate factors associated with successful trial stimulation, patients were classified into two groups (success and failure in trial). We investigated the following factors : age, sex, predominant pain areas (axial, limb, axial combined with limbs), number of operations, duration of preoperative pain, type of electrode (cylindrical/paddle), predominant type of pain (nociceptive, neuropathic, mixed), degree of sensory loss in painful areas, presence of motor weakness, and preoperative Visual Analogue Scale. Results : There were no significant differences between the two groups in terms of age, degree of pain, number of operations, and duration of pain (p>0.05). Univariate analysis revealed that the type of electrode and presence of severe sensory deficits were significantly associated with the success of trial stimulation (p<0.05). However, the remaining variable, sex, type of pain, main location of pain, degree of pain duration, degree of sensory loss, and presence of motor weakness, were not associated with the trial success of SCS for FBSS. Conclusion : Trial stimulation with paddle leads was more successful. If severe sensory deficits occur in the painful dermatomes in FBSS, trial stimulation were less effective.
Keywords
Chronic pain; Failed back surgery syndrome; Spinal surgery; Spinal cord stimulation;
Citations & Related Records
연도 인용수 순위
  • Reference
1 North RB, Lanning A, Hessels R, Cutchis PN : Spinal cord stimulation with percutaneous and plate electrodes : side effects and quantitative comparisons. Neurosurg Focus 2 : e3, 1997
2 Sears NC, Machado AG, Nagel SJ, Deogaonkar M, Stanton-Hicks M, Rezai AR, et al. : Long-term outcomes of spinal cord stimulation with paddle leads in the treatment of complex regional pain syndrome and failed back surgery syndrome. Neuromodulation 14 : 312-318; discussion 318, 2011   DOI   ScienceOn
3 Shealy CN, Mortimer JT, Reswick JB : Electrical inhibition of pain by stimulation of the dorsal columns : preliminary clinical report. Anesth Analg 46 : 489-491, 1967
4 Sparkes E, Raphael JH, Duarte RV, LeMarchand K, Jackson C, Ashford RL : A systematic literature review of psychological characteristics as determinants of outcome for spinal cord stimulation therapy. Pain 150 : 284-289, 2010   DOI   ScienceOn
5 Spiegelmann R, Friedman WA : Spinal cord stimulation : a contemporary series. Neurosurgery 28 : 65-70; discussion 70-71, 1991   DOI
6 Taylor RS : Spinal cord stimulation in complex regional pain syndrome and refractory neuropathic back and leg pain/failed back surgery syndrome : results of a systematic review and meta-analysis. J Pain Symptom Manage 31 (4 Suppl) : S13-S19, 2006   DOI   ScienceOn
7 Taylor RS, Van Buyten JP, Buchser E : Spinal cord stimulation for chronic back and leg pain and failed back surgery syndrome : a systematic review and analysis of prognostic factors. Spine (Phila Pa 1976) 30 : 152-160, 2005   DOI
8 Taylor RS, Van Buyten JP, Buchser E : Spinal cord stimulation for complex regional pain syndrome : a systematic review of the clinical and cost-effectiveness literature and assessment of prognostic factors. Eur J Pain 10 : 91-101, 2006   DOI   ScienceOn
9 Tunks ER, Crook J, Weir R : Epidemiology of chronic pain with psychological comorbidity : prevalence, risk, course, and prognosis. Can J Psychiatry 53 : 224-234, 2008   DOI
10 Waguespack A, Schofferman J, Slosar P, Reynolds J : Etiology of long-term failures of lumbar spine surgery. Pain Med 3 : 18-22, 2002   DOI   ScienceOn
11 Yanamoto F, Murakawa K : The effects of temporary spinal cord stimulation (or spinal nerve root stimulation) on the management of early postherpetic neuralgia from one to six months of its onset. Neuromodulation 15 : 151-154; discussion 154, 2012   DOI   ScienceOn
12 Lehmann TR, LaRocca HS : Repeat lumbar surgery. A review of patients with failure from previous lumbar surgery treated by spinal canal exploration and lumbar spinal fusion. Spine (Phila Pa 1976) 6 : 615-619, 1981   DOI   ScienceOn
13 Manca A, Kumar K, Taylor RS, Jacques L, Eldabe S, Meglio M, 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 : 1047-1058, 2008   DOI   ScienceOn
14 Meglio M, Cioni B, Visocchi M, Tancredi A, Pentimalli L : Spinal cord stimulation in low back and leg pain. Stereotact Funct Neurosurg 62 : 263-266, 1994   DOI
15 North RB, Campbell JN, James CS, Conover-Walker MK, Wang H, Piantadosi S, et al. : Failed back surgery syndrome : 5-year follow-up in 102 patients undergoing repeated operation. Neurosurgery 28 : 685-690; discussion 690-691, 1991   DOI
16 Meyerson BA, Linderoth B : Mode of action of spinal cord stimulation in neuropathic pain. J Pain Symptom Manage 31 (4 Suppl) : S6-S12, 2006
17 Miller B, Gatchel RJ, Lou L, Stowell A, Robinson R, Polatin PB : Interdisciplinary treatment of failed back surgery syndrome (FBSS) : a comparison of FBSS and non-FBSS patients. Pain Pract 5 : 190-202, 2005   DOI   ScienceOn
18 Nachemson AL : Evaluation of results in lumbar spine surgery. Acta Orthop Scand Suppl 251 : 130-133, 1993
19 North RB, Ewend MG, Lawton MT, Piantadosi S : Spinal cord stimulation for chronic, intractable pain : superiority of "multi-channel" devices. Pain 44 : 119-130, 1991   DOI   ScienceOn
20 North RB, Kidd DH, Farrokhi F, Piantadosi SA : Spinal cord stimulation versus repeated lumbosacral spine surgery for chronic pain : a randomized, controlled trial. Neurosurgery 56 : 98-106; discussion 106-107, 2005   DOI
21 North RB, Kidd DH, Olin JC, Sieracki JM : Spinal cord stimulation electrode design : prospective, randomized, controlled trial comparing percutaneous and laminectomy electrodes-part I : technical outcomes. Neurosurgery 51 : 381-389; discussion 389-390, 2002
22 North RB, Kidd DH, Petrucci L, Dorsi MJ : Spinal cord stimulation electrode design : a prospective, randomized, controlled trial comparing percutaneous with laminectomy electrodes : part II-clinical outcomes. Neurosurgery 57 : 990-996; discussion 990-996, 2005   DOI
23 Burchiel KJ, Anderson VC, Wilson BJ, Denison DB, Olson KA, Shatin D : Prognostic factors of spinal cord stimulation for chronic back and leg pain. Neurosurgery 36 : 1101-1110; discussion 1110-1111, 1995   DOI   ScienceOn
24 Burton CV : Failed back surgery patients : the alarm bells are ringing. Surg Neurol 65 : 5-6, 2006   DOI   ScienceOn
25 Chan CW, Peng P : Failed back surgery syndrome. Pain Med 12 : 577-606, 2011   DOI   ScienceOn
26 Campbell CM, Jamison RN, Edwards RR : Psychological screening/phenotyping as predictors for spinal cord stimulation. Curr Pain Headache Rep 17 : 307, 2013   DOI
27 Canlas B, Drake T, Gabriel E : A severe case of complex regional pain syndrome I (reflex sympathetic dystrophy) managed with spinal cord stimulation. Pain Pract 10 : 78-83, 2010   DOI   ScienceOn
28 Celestin J, Edwards RR, Jamison RN : Pretreatment psychosocial variables as predictors of outcomes following lumbar surgery and spinal cord stimulation : a systematic review and literature synthesis. Pain Med 10 : 639-653, 2009   DOI   ScienceOn
29 Chou R : Generating evidence on spinal cord stimulation for failed back surgery syndrome : not yet fully charged. Clin J Pain 24 : 757-758, 2008   DOI   ScienceOn
30 Doleys DM : Psychological factors in spinal cord stimulation therapy : brief review and discussion. Neurosurg Focus 21 : E1, 2006
31 Frey ME, Manchikanti L, Benyamin RM, Schultz DM, Smith HS, Cohen SP : Spinal cord stimulation for patients with failed back surgery syndrome : a systematic review. Pain Physician 12 : 379-397, 2009
32 Kumar K, Taylor RS, Jacques L, Eldabe S, Meglio M, Molet J, et al. : Spinal cord stimulation versus conventional medical management for neuropathic pain : a multicentre randomised controlled trial in patients with failed back surgery syndrome. Pain 132 : 179-188, 2007   DOI   ScienceOn
33 Law JD, Lehman RA, Kirsch WM : Reoperation after lumbar intervertebral disc surgery. J Neurosurg 48 : 259-263, 1978   DOI
34 Beersen N, Redekop WK, de Bruijn JH, Theuvenet PJ, Berg M, Klazinga NS : Quality based social insurance coverage and payment of the application of a high cost medical therapy : the case of spinal cord stimulation for chronic non-oncologic pain in The Netherlands. Health Policy 71 : 107-115, 2005   DOI   ScienceOn
35 Allegri M, Arachi G, Barbieri M, Paulin L, Bettaglio R, Bonetti G, et al. : Prospective study of the success and efficacy of spinal cord stimulation. Minerva Anestesiol 70 : 117-124, 2004
36 Andersson HI, Ejlertsson G, Leden I, Schersten B : Impact of chronic pain on health care seeking, self care, and medication. Results from a population-based Swedish study. J Epidemiol Community Health 53 : 503-509, 1999   DOI
37 Bala MM, Riemsma RP, Nixon J, Kleijnen J : Systematic review of the (cost-)effectiveness of spinal cord stimulation for people with failed back surgery syndrome. Clin J Pain 24 : 741-756, 2008   DOI   ScienceOn
38 Bouhassira D, Attal N, Alchaar H, Boureau F, Brochet B, Bruxelle J, et al. : Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain 114 : 29-36, 2005   DOI   ScienceOn
39 Broggi G, Servello D, Dones I, Carbone G : Italian multicentric study on pain treatment with epidural spinal cord stimulation. Stereotact Funct Neurosurg 62 : 273-278, 1994   DOI
40 Kumar K, Taylor RS, Jacques L, Eldabe S, Meglio M, Molet J, 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 : 762-770; discussion 770, 2008   DOI   ScienceOn