• World Neurosurg · Oct 2020

    Observational Study

    Long-term Multicolumn-Lead Spinal Cord Stimulation Efficacy in Patients Suffering from a Failed Back Surgery Syndrome: A Six-Year Prospective Follow-up Study.

    • Thibault Remacle, Stephane Mauviel, Henri-Jean Renwart, Keyvan Ghassempour, Frederic Belle, Olivier Lückers, Vincent Bex, Jean-Michel Remacle, and Vincent Bonhomme.
    • Department of Neurosurgery, Regional Hospital Center Citadelle, Liege, Belgium; Department of Neurosurgery, University Hospital Center Liege, Liege, Belgium. Electronic address: thibaultremacle@gmail.com.
    • World Neurosurg. 2020 Oct 1; 142: e245-e252.

    ObjectiveThe 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.MethodsIn 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.ResultsOf 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.ConclusionsThe 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.Copyright © 2020 Elsevier Inc. All rights reserved.

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