Updates on the Role of Spinal Cord Stimulation in the Management of Non-Surgical Chronic Lower Back Pain.

Jonathan Quinonez,Amean Amra,Umar Soomro,Shahtaj A Shah,Jesse Kemmerlin,Sujan Poudel,Joel Stein,Trevine Albert,Annie Singh,Vinayak Aryal,Jinal Choudhari,Thakur Shrestha,Fizza Zulfiqar,Samir Ruxmohan

doi:10.7759/cureus.18928

Jonathan Quinonez, Amean Amra + Show 12 more

Open Access

https://doi.org/10.7759/cureus.18928

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Abstract

Studies have shown that spinal cord stimulation (SCS) therapy is effective in the management of chronic low back pain. It plays a role by minimizing the intensity of chronic pain, improving the quality of life index, reducing the intake of narcotic analgesics, and increasing the functional improvement in the working environment. However, spinal cord stimulation therapy is not universal because of the complications in the procedure itself, the invasive nature of the treatment, and cost-effectiveness. Therefore, the proper selection of the patients is necessary to get the maximum benefit from the treatment. The study's main objective is to determine the role of spinal cord stimulation in treating non-surgical patients with chronic low back pain. The article will review the mechanism, outcomes, efficacy, predisposing factors in the success and failure of the treatment and indications, contraindications, and selection of patients undergoing spinal cord stimulation therapy. A manual search of the literature was done using databases like Google Scholar and PubMed using the keywords: spinal cord, stimulation, chronic, and low back pain. A total of 37 articles were included in the study after considering the inclusion and exclusion criteria. Spinal cord stimulation therapy effectively treats refractory lower back pain, considering the technology and mechanism of action. The authors conclude that spinal cord stimulation therapy can be used to manage chronic low back pain, other neuropathic pain, and ischemic pain when other standard treatment methods have failed and the pain persisted for more than six months.

Highlights

BackgroundChronic lower back pain is a common comorbidity worldwide and the fifth most common in the United States [1]
Spinal cord stimulation is a well-accepted form of treatment of neuropathic pain
The study's main objective is to determine the role of spinal cord stimulation in treating non-surgical patients with chronic low back pain

Summary

Introduction

Chronic lower back pain is a common comorbidity worldwide and the fifth most common in the United States [1]. The study's main objective is to determine the role of spinal cord stimulation in treating non-surgical patients with chronic low back pain. The article will give a basic review of the mechanism, outcomes, efficacy, predisposing factors in the success or failure of the treatment, and indications, contraindications, and selection of patients undergoing spinal cord stimulation therapy. The primary and secondary outcomes in the patients after SCS therapy in the different studies show that it is effective in treating patients with lower back pain in non-surgical patients. SCS proves to be cost-effective, as it is less expensive than surgical treatment because once the electrodes are implanted, the cost-utility decreases significantly It would be more appropriate in the long term, as the benefit of SCS therapy is much cheaper and effective than other treatment modalities in patients with chronic lower back pain. Proper selection of patients minimizes the unnecessary invasive intervention and maximizes the chance of good outcomes

Conclusions

Disclosures

Guan Y

Findings

18. Ware JE Jr