Presented at the 2012 AAPM Annual Meeting « Back

Spinal Cord Stimulation Efficacy: Review of 5 Years Experience from an Academic Center Database

Elias Veizi, MD PhD, elias.veizi@uhhospitals.org¹, Salim Hayek, MD PhD², (1) University Hospitals of Cleveland, Cleveland, Ohio, (2) Case Western Reserve University, Cleveland, Ohio

Introduction: Spinal cord stimulation (SCS) is an ever growing field that has been widely applied to treat intractable pain entities since 1967. Accepted indications include postlaminectomy pain, CRPS, peripheral neuropathy, and visceral pain. Several authors have reported case series and few randomized trials (Kemler et al., 2005; North et al., 2008). Robust analysis in large SCS patient registries is very useful. Purpose The purpose of this study is to report the 3-year experience of an academic pain medicine practice on the use of SCS for chronic nonmalignant pain. Study Design: This is a retrospective, single-center database review of all SCS trials/implants. Over a 5-year period (2006–2011) in a single academic center, 275 patients were subjected to a trial of SCS. 189 patients had a satisfactory outcome (>50% improvement in pain and activity) to justify a permanent implant. Results: Trial/implant ratio in the general population was 68.4% and disease specific was 71% for FBSS, 64.7% for CRPS, 80% for SFN and 60% for PHN/PN, and 80% for visceral pain post differential nerve block. NRS cores decreased from 8.5 to 4.3 at 1 month and 5.2 at 12 months. The number of back surgeries was not correlated with the satisfaction leading to SCS implant (14% of patient on failed trail group and 15% on successful trial group). Conclusions: SCS can provide significant long-term relief in various conditions with chronic intractable pain. Stringent patient selection and rigorous assessment of the pain quality affects the efficacy of this treatment. References: 1)Kemler MA, de Vet HC, Barendse GA, van den Wildenberg FA, van Kleef M: Spinal cord stimulation for chronic reflex sympathetic dystrophy--five-year follow-up. N Engl J Med 2006, 354(22):2394-2396. 2)Kumar K, Taylor RS, Jacques L, Eldabe S, Meglio M, Molet J, Thomson S, O'Callaghan J, Eisenberg E, Milbouw G et al: The effects of spinal cord stimulation in neuropathic pain are sustained: a 24-month follow-up of the prospective randomized controlled mul

Funding: None

Figure 1. Median group impedance by visit and position