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Updated: Jan 10, 2026
Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation
Published on: June 26, 2018
Systematic Review and Meta-Analysis of Spinal Cord Stimulation for Chronic Nonsurgical Refractory Back Pain With or
Jan Willem Kallewaard1, Sarah Nevitt2, Michelle Maden3
1Department of Anaesthesiology and Pain Management, Rijnstate Hospital, Velp, The Netherlands; Department of Anesthesiology and Pain Medicine, Amsterdam University Medical Centre, Amsterdam, The Netherlands.
Objectives:
The aim of this systematic review and meta-analysis was to evaluate the safety and effectiveness of spinal cord stimulation (SCS) on pain intensity, physical function, and health-related quality of life (HRQoL) for people experiencing persistent spinal pain syndrome type 1 (PSPS-T1), also known as nonsurgical refractory back pain with or without leg pain, and to assess the durability of SCS treatment effects.
Materials And Methods:
MEDLINE, Cochrane Central Register of Controlled Trials, Embase, and WikiStim data bases were searched from inception to December 19, 2024. Eligible studies included randomized controlled trials (RCTs) with any follow-up duration, and non-RCTs with ≥12-month follow-up. Outcomes included pain intensity, physical function, and HRQoL. Risk of bias was assessed using the revised Cochrane risk-of-bias and National Institutes of Health tools. Certainty of the evidence for the comparisons and outcomes included in the meta-analysis was assessed using the Grading of Recommendations Assessment, Development and Evaluation framework. The measure of treatment effect was mean difference (MD) or odds ratio and 95% CI.
Results:
Overall, 19 reports of 16 unique studies were included in the review. Meta-analysis shows significant reductions in pain with SCS compared with conventional medical management (CMM) at six-month follow-up (MD 5.67; 95% CI: 4.60-6.74). Statistically significant results in favor of SCS compared with CMM were observed for physical function and HRQoL. Meta-analysis of non-RCT data showed significant improvements in pain intensity, physical function, and HRQoL up to 24 months compared with baseline.
Conclusions:
All included studies of SCS for PSPS-T1 indicated significant improvements in pain intensity, physical function, and HRQoL when compared with CMM or baseline.
