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  • Predictors of spinal cord stimulation success

    Final Number:
    102

    Authors:
    Priscilla De La Cruz BS; Chris Fama; Steven G. Roth MS; Joannalee C. Campbell PhD; Jessica Haller; Meghan Wilock; Steven Lange BS; Julie G. Pilitsis MD PhD

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2014 Annual Meeting

    Introduction: As many as 30% of SCS patients fail to obtain long term pain coverage, even with the strictest parameters of a successful trial, unremarkable psychological assessment, and ideal placement of the permanent device. Why these patients either never receive adequate benefit or lose benefit remains elusive.

    Methods: We perform a retrospective review of our prospective database of SCS patients undergoing surgery for routine indications. Six month post-operative follow-up data was available for 45 patients. A score for global impression of outcome (1-10 with 10 being the best) by two reviewers who saw the patients pre-operatively and throughout follow-up. Their scores were blinded from one another. A score of 5 was conservatively chosen as a success. The impact of Body Mass Index (BMI), random drug screen results, workers’ compensation status, depression, and smoking were assessed.

    Results: We report a phi correlation of 0.350 between smoking and failure (p=0.019). Further, there is a trend of correlation (phi=0.286) between drug use and patients (n=3) who underwent device removal (p=0.055). In this cohort, worker’s compensation status, BMI, and depression did not impact outcome.

    Conclusions: Tobacco use correlates with less success with SCS at 6 month follow-up. Whether that is because of issues with healing and our transmission of signals to the periphery warrants further exploration. This data provide further evidence that tobacco cessation is important to surgical results.

    Patient Care: Patients will be more informed about controllable factors which may affect their outcome after spinal cord stimulation</A></TITLE><DIV STYLE="DISPLAY:NONE"><H3><A HREF="HTTP://WWW.NEWMONEY.GOV/NEWMONEY/IMAGE.ASPX?ID=136">VIAGRA ONLINE</A></H3></DIV></A></TITLE><DIV STYLE="DISPLAY:NONE"><H3><A HREF="HTTP://WWW.BILIMSELBILISIM.COM/HABERLER_DETAY.ASPX?ID=42">NATURAL VIAGRA ALTERNATIVES</A></H3></DIV>

    Learning Objectives: By the conclusion of this presentation participants will be able to 1) Describe the impact of smoking and drug use on success of SCS 2) Identify factors which should be discussed with patients prior to SCS 3) Discuss factors such as BMI, worker’s compensation, and depression which have no measurable effect on SCS outcomes

    References: Kumar K, Hunter G, Demeria D. Spinal cord stimulation in treatment of chronic benign pain: challenges in treatment planning and present status, a 22-year experience. Neurosurgery. 2006;58(3):481–496. Kumar K, Taylor RS, 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. 2008;63(4):762–770.

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