Spinal cord stimulation in failed back surgery syndrome

Abstract

Introduction. A common cause of chronic pain after back surgery is failed back surgery syndrome, characterized by the development, persistence or recurrence of neuropathic pain in the absence of clear anatomical complications from the surgery. One of the most effective treatment methods for failed back surgery syndrome is permanent spinal cord stimulation. Study aim. To assess the efficacy and safety of chronic spinal cord stimulation in failed back surgery syndrome. Materials and methods. In our study, after a stimulation trial final neurostimulation was performed in 34 patients with neuropathic pain and lack of improvement from the pharmacological treatment. Results. Six months after the operation, there was a reduction in the average scores on the visual analogue scale for the daily average and maximum pain, as well as a reduction in the severity of neuropathic pain as measured by the PainDetect scale (by 54.4% 50.7% and 57.3%, respectively), which corresponds to the method’s efficacy criteria found in the literature. The majority of patients noted a significant improvement in their quality of life and a reduced need for pain relief. Complications occurred in 26.4% of patients overall, including intraoperative damage to the dura mater, infection at the generator implantation site, and electrode displacement relative to the initial position, requiring correction. None of the patients experienced worsening of the neurological symptoms.