Spinal cord stimulation in failed back surgery

Abstract

Objective: Spinal cord stimulation is used for treating failed back surgery syndrome, chronic arachnoiditis, peripheral neuropathies, postamputation phantom pain, complex regional pain syndrome and pain secondary to spinal cord injury. In this study we present 7 cases with intractable neuropathic radicular pain which developed following spine surgery. Material and Methods: Spinal cord stimulation was applied to 7 (3male/4 female) patients who had failed back surgery syndrome and pain resistant to medical and invasive methods, with the council decision, which included neurosurgery, neurology, and psychiatry. One week stimulation trial was applied to all cases. Results:The mean age of the patients was 54.85±7.64 years. The mean of pain intensity in Visual Analog Scale was 8.71±0.74 at preoperative status and post operative pain intensity was 2.27±0.67 at 6 months. Pain intensity significantly decreases after spinal cord stimulation (p=0.000). One of the three cases who had unsuccessful trial period received morphine pump implantation, and percutaneous lumbar sympathectomy was applied to another one. One case who received permanent implantation was replaced to another location due to skin erosion. There was no morbidity. Conclusion: Spinal cord stimulation is an effective tool in reducing pain, in patients who have unsuccessful lower back surgery with the correct indications.