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Related Experiment Videos

Spinal cord stimulation for chronic pain.

A Mailis-Gagnon1, A D Furlan, J A Sandoval

  • 1Department of Medicine, Comprehensive Pain Program, 399 Bathurst Street, Fell Pavillion 4F811, Toronto, Ontario, Canada, M5T 2S8.

The Cochrane Database of Systematic Reviews
|July 22, 2004
PubMed
Summary

Spinal cord stimulation (SCS) shows limited evidence for treating chronic pain like Failed Back Surgery Syndrome. More high-quality trials are needed to confirm its effectiveness and optimal use.

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Area of Science:

  • Neurology
  • Pain Management
  • Medical Devices

Background:

  • Spinal cord stimulation (SCS) is a therapy for chronic pain involving electrical pulses delivered to the spinal cord.
  • Implantation methods include laminectomy or percutaneous techniques, with power supplied by internal batteries or external transmitters.
  • The precise mechanism of action for SCS remains unclear.

Purpose of the Study:

  • To evaluate the efficacy and effectiveness of spinal cord stimulation (SCS) in managing specific chronic pain conditions.
  • To identify and assess complications and adverse effects associated with SCS procedures.

Main Methods:

  • Searched MEDLINE, EMBASE, and CENTRAL databases up to September 2003, supplemented by textbooks, reference lists, and expert/manufacturer consultations.

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  • Included randomized controlled trials (RCTs) and non-randomized controlled clinical trials (CCTs) with a control group for chronic pain patients.
  • Two reviewers independently selected studies, assessed quality (one blinded), and extracted data; analysis used qualitative methods (best evidence synthesis).

    • Main Results:

    • Two RCTs (81 patients) met inclusion criteria; one high-quality, one low-quality.
    • Included patients had Complex Regional Pain Syndrome Type I or Failed Back Surgery Syndrome, with follow-up of 6-12 months.
    • Both studies indicated SCS effectiveness, but meta-analysis was not performed due to small sample size and heterogeneity.

    Conclusions:

    • Limited evidence supports SCS for Failed Back Surgery Syndrome and Complex Regional Pain Syndrome Type I.
    • Further trials are necessary to confirm SCS efficacy for specific chronic pain types.
    • Discussion on optimal trial designs for evaluating SCS interventions is warranted.