Long-Term Multicolumn-Lead Spinal Cord Stimulation Efficacy in Patients with Failed Back Surgery Syndrome: A Six-Year Prospective Follow-up Study

• Published in: World neurosurgery Vol. 142; pp. e245 - e252
• Main Authors: Remacle, Thibault, Mauviel, Stephane, Renwart, Henri-Jean, Ghassempour, Keyvan, Belle, Frederic, Lückers, Olivier, Bex, Vincent, Remacle, Jean-Michel, Bonhomme, Vincent
• Format: Journal Article Web Resource
• Language: English
• Published: United States Elsevier Inc 01-10-2020
• Subjects: Activities of Daily Living; Analgesics; Analgesics - therapeutic use; Anesthesia & intensive care; Anesthésie & soins intensifs; Failed back surgery syndrome; Failed Back Surgery Syndrome - physiopathology; Failed Back Surgery Syndrome - therapy; Female; Follow-Up Studies; Human health sciences; Humans; Male; Middle Aged; Neurology (clinical); Pain Measurement; Patient Outcome Assessment; Prospective Studies; Sciences de la santé humaine; Sleep; Spinal cord stimulation; Spinal Cord Stimulation - methods; Surgery; Treatment Outcome; Patient outcome assessment; SCS; Failed back surgery syndrome; LP; MRI; Spinal cord stimulation; VAS; FBSS; Follow-up studies; BP; DAL
• ISSN: 1878-8750; 1878-8769; 1878-8769
• DOI: 10.1016/j.wneu.2020.06.181

The use of multicolumn-lead spinal cord stimulation (SCS) to control back pain (BP) and leg pain (LP) in patients with failed back surgery syndrome (FBSS) in the short term and mid-term has been well documented. Our study investigated whether SCS remained efficient after 72 months.
In an observational, single-center study, we assessed SCS efficacy in 62 patients with FBSS patients. BP, LP, and magnitude of daily activity limitation (DAL) were graded using a 0–10 visual analog scale (VAS) preoperatively and at 2, 6, 12, 24, 36, and 72 months after SCS implantation. Sleep quality, use of medications, and complications were also recorded.
Of the 62 patients, 15 with complete follow-up data available were still using their SCS device at 72 months (SCS+). For these patients, the VAS scores for BP, LP, and DAL had changed from a median of 9 (interquartile range [IQR], 8.5–10), 7 (IQR, 6–8), and 8 (IQR, 8–9) preoperatively to a median of 4 (IQR, 3–4.5), 3 (IQR, 1.5–3.5), and 3 (IQR, 2–4) at 72 months. Their quality of sleep and analgesic medication consumption had also improved. In a subset of patients no longer using the SCS device after 72 months (SCS−), the VAS scores for BP, LP, and DAL, quality of sleep, and medication consumption were comparable to those for the SCS+ group. The SCS− group was less satisfied with the technique and were less professionally active than were the SCS+ group.
The SCS device provides sustained beneficial effects on BP, LP, DAL, sleep, and medication consumption in patients with FBSS still using it at 72 months postoperatively. Further studies are needed to identify the factors of adherence to the technique and the chances of success compared with the natural evolution of FBSS.