Spinal cord stimulation versus conventional medical management for neuropathic pain: A multicentre randomised controlled trial in patients with failed back surgery syndrome
By Krishna Kumar, R. Taylor, L. Jacques, S. Eldabe, M. Meglio, J. Molet, S. Thomson, J. O’Callaghan, E. Eisenberg, G. Milbouw and 4 more. Pain, 2007
1,091 citations recorded by the source corpus.
Abstract Patients with neuropathic pain secondary to failed back surgery syndrome (FBSS) typically experience persistent pain, disability, and reduced quality of life. We hypothesised that spinal cord stimulation (SCS) is an effective therapy in addition to conventional medical management (CMM) in this patient population. We randomised 100 FBSS patients with predominant leg pain of neuropathic radicular origin to receive spinal cord stimulation plus conventional medical management (SCS group) or conventional medical management alone (CMM group) for at least 6 months. The primary outcome was the proportion of patients achieving 50% or more pain relief in the legs. Secondary outcomes were improvement in back and leg pain, health‐related quality of life, functional capacity, use of pain medication and non‐drug pain treatment, level of patient satisfaction, and incidence of complications and adverse effects. Crossover after the 6‐months visit was permitted, and all patients were followed up to 1 year. In the intention‐to‐treat analysis at 6 months, 24 SCS patients (48%) and 4 CMM patients (9%) (p < 0.001) achieved the primary outcome. Compared with the CMM group, the SCS group experienced improved leg and back pain relief, quality of life, and functional capacity, as well as greater treatment satisfaction (p ⩽ 0.05 for all comparisons). Between 6 and 12 months, 5 SCS patients crossed to CMM, and 32 CMM patients crossed to SCS. At 12 months, 27 SCS patients (32%) had experienced device‐related complications. In selected patients with FBSS, SCS provides better pain relief and improves health‐related quality of life and functional capacity compared with CMM alone.
Subfields: Anesthesiology and Pain Medicine, Pharmacology, Physiology
View Paper: https://www.semanticscholar.org/paper/b07920b965e39bd00e9cb30c9fb65a110dfe011c
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In Anesthesiology and Pain Medicine
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Citations in the corpus
- Interventional Therapies, Surgery, and Interdisciplinary Rehabilitation for Low Back Pain: An Evidence-Based Clinical Practice Guideline From the American Pain Society (2009, background): “com/A840) is associated with moderate benefits compared with repeat surgery(128) or continued medical management.(129) However, over one-quarter of patients experience complications following spinal cord stimulator placement, including electrode migration, infection or wound breakdown, generator poc”
- EFNS guidelines on neurostimulation therapy for neuropathic pain (2007, background): “Concerning FBSS there are two class-II RCTs, the first showing that SCS is more effective than reoperation [26] and the second that its addition is more effective than conventional medical care alone [27,28].”