Spinal Cord Stimulation in Failed Back Surgery Syndrome: Review of Clinical Use, Quality of Life and Cost-Effectiveness

• Published in: Asian spine journal Vol. 10; no. 6; pp. 1195 - 1204
• Main Authors: Waszak, Przemyslaw M, Modrić, Marta, Paturej, Agnieszka, Malyshev, Stanislav M, Przygocka, Agnieszka, Garnier, Hanna, Szmuda, Tomasz
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Spine Surgery 01.12.2016; Korean Spine Society; 대한척추외과학회
• Subjects: Back pain; Back surgery; Chronic pain; Clinical medicine; Control theory; Epidural; Etiology; Failed back surgery syndrome; FDA approval; Interdisciplinary aspects; Low back pain; Nonsteroidal anti-inflammatory drugs; Pain management; Patient satisfaction; Patients; Quality of life; Rehabilitation; Review; Risk factors; Spinal cord; Spinal cord stimulation; Surgery; 정형외과학; United States > US; Failed back surgery syndrome; Low back pain; Pain management; Spinal cord stimulation
• ISSN: 1976-1902; 1976-7846
• DOI: 10.4184/asj.2016.10.6.1195

Failed back surgery syndrome (FBSS) is complex and recurrent chronic pain after spinal surgery. Several important patient and surgery related risk factors play roles in development of FBSS. Inadequate selection of the candidates for the spinal surgeries is one of the most crucial causes. The guidelines suggest that conservative management featuring pharmacologic approaches and rehabilitation should be introduced first. For therapy-refractory FBSS, spinal cord stimulation (SCS) is recommended in selected patients. Treatment efficacy for FBSS has increased over the years with the majority of patients experiencing pain relief and reduced medicinal load. Improved quality of life can also be achieved using SCS. Cost-effectiveness of SCS still remains unclear. However evidence for SCS role in FBSS is controversial, SCS can be beneficial for carefully classified patients.