Long-term outcomes of spinal cord stimulation with paddle leads in the treatment of complex regional pain syndrome and failed back surgery syndrome

Nathaniel C Sears; Andre G Machado; Sean J Nagel; Milind Deogaonkar; Michael Stanton-Hicks; Ali R Rezai; Jaimie M Henderson

doi:10.1111/j.1525-1403.2011.00372.x

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Journal article

Peer reviewed

Long-term outcomes of spinal cord stimulation with paddle leads in the treatment of complex regional pain syndrome and failed back surgery syndrome

Nathaniel C Sears, Andre G Machado, Sean J Nagel, Milind Deogaonkar, Michael Stanton-Hicks, Ali R Rezai and Jaimie M Henderson

Neuromodulation (Malden, Mass.), Vol.14(4), pp.312-318

07/2011

DOI: 10.1111/j.1525-1403.2011.00372.x

PMID: 21992424

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Abstract

Spinal cord stimulation (SCS) is frequently used to treat chronic, intractable back, and leg pain. Implantation can be accomplished with percutaneous leads or paddle leads. Although there is an extensive literature on SCS, the long-term efficacy, particularly with paddle leads, remains poorly defined. Outcome measure choice is important when defining therapeutic efficacy for chronic pain. Numerical rating scales such as the NRS-11 remain the most common outcome measure in the literature, although they may not accurately correlate with quality of life improvements and overall satisfaction. We reviewed the medical records of patients with failed back surgery syndrome (FBSS) or complex regional pain syndrome (CRPS) implanted with SCS systems using paddle leads between 1997 and 2008 at the Cleveland Clinic with a minimum six-month follow-up. Patients were contacted to fill out a questionnaire evaluating outcomes with the NRS-11 as well as overall satisfaction. A total of 35 eligible patients chose to participate. More than 50% of the patients with CRPS reported greater than 50% pain relief at a mean follow-up of 4.4 years. Approximately 30% of the FBSS patients reported a 50% or greater improvement at a mean follow-up of 3.8 years. However, 77.8% of patients with CRPS and 70.6% of patients with FBSS indicated that they would undergo SCS surgery again for the same outcome. Patients with CRPS and FBSS have a high degree of satisfaction, indexed as willingness to undergo the same procedure again for the same outcome at a mean follow-up of approximately four years. The percentage of satisfaction with the SCS system is disproportionally greater than the percentage of patients reporting 50% pain relief, particularly among patients with FBSS. This suggests that the visual analog scale may not be the optimal measure to evaluate long-term outcomes in this patient population.

Failed Back Surgery Syndrome - therapy

Follow-Up Studies

Electric Stimulation Therapy - instrumentation

Humans

Middle Aged

Male

Electrodes, Implanted

Time

Patient Satisfaction

Complex Regional Pain Syndromes - therapy

Outcome Assessment (Health Care) - statistics & numerical data

Adult

Female

Surveys and Questionnaires

Retrospective Studies

Spinal Cord - physiopathology

Pain Measurement

Details

Title: Subtitle: Long-term outcomes of spinal cord stimulation with paddle leads in the treatment of complex regional pain syndrome and failed back surgery syndrome
Creators: Nathaniel C Sears - Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
Andre G Machado
Sean J Nagel
Milind Deogaonkar
Michael Stanton-Hicks
Ali R Rezai
Jaimie M Henderson
Resource Type: Journal article
Publication Details: Neuromodulation (Malden, Mass.), Vol.14(4), pp.312-318
Publisher: United States
DOI: 10.1111/j.1525-1403.2011.00372.x
PMID: 21992424
ISSN: 1094-7159
eISSN: 1525-1403
Language: English
Date published: 07/2011
Academic Unit: Ophthalmology and Visual Sciences
Record Identifier: 9983980075802771

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