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  • The Use of Epidural Spinal Cord Stimulation in Pain Management of Chronic Failed Back Surgery Syndrome due to Thoraco-Lumbosacral Arthrodesis: A Retrospective Case Series

    Final Number:

    Rogerio Aires MD, PHD; Paulo Henrique Pires de Aguiar MD PhD; Bruno Camporeze; Iracema Estevão; Mariany Melo; Fabio Jundy Nakasone

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2017 Annual Meeting - Late Breaking Science

    Introduction: The most common location of chronic neuropathic pain is the back and legs, and until 40% of patients who have undergone lumbosacral spine surgery experience persistent or recurrent pain. Chronic failed back surgery syndrome (FBSS) result in patients’ loss of function, reduced quality of life and increased costs to the society. The spinal cord stimulation (SCS) has been described as a valuable neuromodulation procedure in the management of chronic medically untreated neuropathic pain.

    Methods: The authors selected retrospectively, from 2013 to 2017, patients affected by FBSS due to thoraco-lumbosacral arthrodesis (n=70) that were treated by SCS and they were followed-up for minimum periods of 6 months. Furthermore, a bibliographical search from 1950 to 2017 was performed using the indexed databases aiming to based the discussion of results showed in this study.

    Results: The authors showed the presence of 36 men (51.4% of the patients) and 34 women (48.6% of the patients) in the study, whose the mean age was 47.9+10.1 years. We showed absence of complication in 83% (n=58) of patients, while 17% (n=12) of patients showed the presence of lead migration (7.1%, n=5), skin infection (7.1%, n=5), CSF leak (1.4%, n=1) and break of lead (1.4%, n=1). The authors showed the presence of significant (p=0,002) reduction of pain intensity rates ranging from 8.8+0.9 to 3.8+1.8 and 2.5+2.0 points in NDS preoperative, postoperative of 15 days and 6 months, respectively.

    Conclusions: The SCS is an initial procedure in which substantial assessment demonstrated an effective therapy in patients with medically refractory neuropathic pain in patients affected by FBSS.

    Patient Care: The adequate management of pain in patients affected by chronic FBSS can be result in decrease of patients’ loss of function, improvement of quality of life, as well as the reduction of governmental or particular health costs.

    Learning Objectives: The goal of this study is discuss the risks, complications and results as well as the prognosis of SCS in patients affected by chronic FBSS based on literature review and personal casuistic of the authors.

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