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Spinal cord stimulation revisited

R Segal1, B R Stacey, T E Rudy

  • 1Department of Neurological Surgery, University of Pittsburgh, PA, USA.

Neurological Research
|July 17, 1998
PubMed
Summary
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A rigid selection protocol for spinal cord stimulation (SCS) significantly improved outcomes for intractable pain patients. This patient selection method maximized successful SCS treatment, offering sustained pain relief and a high likelihood of repeat treatment choice.

Area of Science:

  • Neurosurgery
  • Pain Management
  • Neurology

Background:

  • The efficacy of spinal cord stimulation (SCS) for intractable pain is debated.
  • Previous studies lack consistent patient selection criteria, potentially affecting outcomes.
  • Standardized hardware and surgical techniques are crucial for SCS success.

Purpose of the Study:

  • To evaluate the success rate of SCS in intractable pain patients using a strict, multidisciplinary selection protocol.
  • To assess the long-term efficacy and patient satisfaction with SCS.
  • To identify factors contributing to successful SCS outcomes.

Main Methods:

  • A cohort of 27 consecutive patients with intractable nonmalignant pain (except one) were analyzed.
  • A rigid selection protocol included: confirmed diagnosis, non-feasibility of surgery, failure of conservative management, and psychological evaluation.

Related Experiment Videos

  • All patients underwent a 3-day SCS trial; successful candidates received an implanted Itrel II System pulse-generator.

    • Main Results:

    • 24 out of 27 patients received an implanted SCS system after a successful trial.
    • Pain reduction was sustained in 22 of 24 patients using the stimulator, with high patient satisfaction.
    • No significant morbidity was reported; improvements in Q-SART and thermography were noted in RSD patients.

    Conclusions:

    • A rigid, multidisciplinary patient selection protocol can maximize the success rate of spinal cord stimulation for intractable pain.
    • Strict adherence to neurosurgical techniques minimizes infection risk.
    • Careful hardware selection reduces the incidence of device malfunction.