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Attrition with spinal cord stimulation.

Stacey A Mann1,2, Elizabeth Sparkes3, Rui V Duarte2,4

  • 1a Faculty of Health, Birmingham City University , Birmingham , UK.

British Journal of Neurosurgery
|June 19, 2015
PubMed
Summary
This summary is machine-generated.

Spinal cord stimulation (SCS) initially reduces chronic neuropathic pain and disability. However, these benefits may decrease over time, with pain increasing by 18 months, suggesting a potential placebo effect at 6 months.

Keywords:
attritionchronic painclinical efficacyneuropathic painspinal cord stimulation

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Area of Science:

  • Neurology
  • Pain Management
  • Neurosurgery

Background:

  • Chronic neuropathic pain significantly impacts patient quality of life.
  • Spinal cord stimulation (SCS) is a treatment option for refractory neuropathic pain.
  • Long-term efficacy of SCS requires further investigation.

Purpose of the Study:

  • To evaluate the long-term effectiveness of SCS in reducing pain intensity and disability.
  • To assess pain and disability levels up to 18 months post-SCS implantation.
  • To determine if the benefits of SCS diminish over time.

Main Methods:

  • Prospective study involving 48 patients with chronic neuropathic pain.
  • Pain intensity measured by Visual Analog Scale (VAS) and disability by Oswestry Disability Index (ODI).
  • Assessments conducted at baseline, and at 6, 12, and 18 months post-SCS.

Main Results:

  • Pain intensity significantly decreased from baseline to all follow-up points, with the greatest reduction at 6 months.
  • Pain intensity significantly increased from 6 months to 12 and 18 months.
  • Pain-related disability decreased significantly at 6 and 12 months but not at 18 months, with an increase between 6 and 18 months.

Conclusions:

  • The pain-reducing effects of SCS may diminish over an 18-month period.
  • The significant improvements observed at 6 months might be partly attributed to a placebo effect.
  • Long-term monitoring is crucial to understand the sustained efficacy of SCS for neuropathic pain.