Spinal Cord Stimulation to Treat Low Back Pain in Patients With and Without Previous Spine Surgery

Abstract

Little is known about the effects of spinal cord stimulation (SCS) on chronic low back pain (CLBP) patients with no history of previous spine surgery. Using our prospectively collected database, we evaluate improvements in patients with and without previous spine surgery one-year post SCS implantation. Subjects completed outcome metrics pre-operatively and one-year post-implantation including Numeric Rating Scale (NRS), McGill Pain Questionnaire (MPQ), Oswestry Disability Index (ODI), Beck's Depression Inventory (BDI), and Pain Catastrophizing Scale (PCS). We enrolled 134 patients; 82 patients had previous spine surgery and 52 patients did not. At one-year post-SCS implantation, patients with previous spine surgery showed improvements in worst pain experienced, least pain experienced, average pain experienced, pain felt currently, MPQ, MPQ sensory, MPQ affective, PCS, PCS helplessness, PCS rumination, PCS magnification, ODI, and BDI scores (p < 0.001, p=0.005, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p=0.03, p=0.01, p=0.02, p < 0.001, p=0.05, p < 0.001, p=0.017, respectively). Likewise, patients without previous spine surgery showed improvements in worst pain experienced, least pain experienced, average pain experienced, pain felt currently, MPQ, MPQ sensory, PCS, PCS helplessness, PCS rumination, PCS magnification, ODI, and BDI scores (p < 0.001, p=0.005, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001, p=0.008, p < 0.001, p < 0.001, respectively). Patients without previous spine surgery showed greater improvements for average pain PCS helplessness (p=0.01). Patients with and without previous spine surgery showed similar improvements in pain intensity, pain quality, feelings of rumination and magnification, functional disability, and depression severity. SCS can improve CLBP regardless of whether patients have had previous spine surgery.