Spinal cord stimulation: a 20-year retrospective analysis in 260 patients

Introduction. Spinal cord stimulation (SCS) is used clinically by many pain physicians and neurosurgeons alike without regard to their own outcome data. Methods. We reviewed our 20-year experience retrospectively of patients receiving SCS implants and analyzed our data by pain type and group. Results. We present 260 patients, 140 men and 120 women. The most frequent type of pain in our series was neuropathic pain in 44.25% and the most frequent diagnosis was peripheral vascular disease (PVD) with 98 cases. The second was failed back surgery syndrome (FBSS) with 65 cases and the third was complex regional pain syndrome type I (CRPS I), with 40 cases. In CRPS group, the mean visual analog scale (VAS) of this group was 77.89 ± 13.38. In total, 5% had no pain relief, 40% had poor pain relief, 47.5% had good pain relief, and 7.5% had excellent pain relief. In FBSS group, the mean VAS was 79.62 ± 11.69 mm. A total of 13.80% had no pain relief at all, 35.39% had poor pain relief, 50.76% had good pain relief, and there were no patients in this group who had complete pain relief. A total of 98 patients, 78 men and 20 women, were diagnosed with PVD. The mean VAS of this group was 69.75 ± 14.36 mm. A total of 11.22% had poor pain relief, 87.75% had good pain relief. One patient had complete pain relief and all patients in this group perceived at least some improvement in their symptoms. The rate of complications was close to 28% in our overall sample. Conclusions. In conclusion, we demonstrated the utility over time of this type of treatment is comparable with other series of efficacy of SCS. The analgesic efficacy was close to 65% in the overall group. The therapy was not free of complications. The preponderance of our patients was patients with the diagnosis of PVD and our results in this group of patients were excellent. These excellent results of more than 90% improvement suggest to us that SCS be considered as a first-line approach to the clinical management of patients with pain and ulcer of PVD.