Narcotic Addiction in Failed Back Surgery Syndrome

Chen, Yuan‐Chuan; Lee, Ching-Yi; Chen, Shiu‐Jau

doi:10.1177/0963689718796072

Cited by 12 publications

(13 citation statements)

References 72 publications

(131 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As drug use in FBSS patients has increasingly become a concern, 8 it is significant that the proportion of the SCS+CMM group using opioids to manage pain dropped to 30.77%. The corresponding decrease in anticonvulsant use to 23.08% in the SCS+CMM group is consistent with the Pain Detect Questionnaire results at the end of the observational period, even though SCS+CMM patients reported more pain at baseline than the CMM group.…”

Section: Discussionmentioning

confidence: 99%

“…As drug use in FBSS patients has increasingly become a concern, 8 it is significant that the proportion of the SCS +CMM group using opioids to manage pain dropped to 30.77%. The corresponding decrease in anticonvulsant use to 23.08% in the SCS+CMM group is consistent with the Also, due to the number of professionals working together, pain unit management might result in an increase of effectiveness of therapy for FBSS patients as, regardless of the treatment option, a multidisciplinary approach is recommended.…”

Section: Discussionmentioning

confidence: 99%

“…5,7 Proper clinical management of FBSS should aim not only to alleviate pain, but also to improve physical function and HRQoL and lower drug dependency. Since narcotic use in FBSS patients has become an issue 8 accentuated by the ongoing opioid crisis, 9,10 re-evaluation of clinical approaches in the treatment of FBSS is important. SCS is underutilized 11,12 and this calls for an additional re-evaluation in a real-world setting.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Real-World Cost-Effectiveness Analysis of Spinal Cord Stimulation vs Conventional Therapy in the Management of Failed Back Surgery Syndrome

Rojo¹,

Hernández²,

Martínez³

et al. 2021

JPR

View full text Add to dashboard Cite

Purpose Failed back surgery syndrome (FBSS) causes disability and lowers health-related quality of life (HRQoL) for patients. Many patients become refractory to conventional medical management (CMM) and spinal cord stimulation (SCS) is advised. However, comparative cost-effectiveness research of both clinical approaches still lacks further evidence. This probabilistic cost-effectiveness analysis compares CMM versus SCS plus CMM in FBSS patients for a 5-year period in Spain. Patients and Methods Patient-level data was obtained from a 2-year real-world study (SEFUDOCE) of adults diagnosed with FBSS who were treated with CMM or SCS. Incremental cost-effectiveness ratios (ICER) were estimated in terms of direct clinical cost and quality-adjusted life years (QALYs). Costs (€ for 2019) were estimated from the Spanish National Health Service (NHS) perspective. We applied a yearly discount rate of 3% to both costs and outcomes and performed a probabilistic sensitivity analysis using bootstrapping. Results After 2 years, the health-related quality of life measured by the EQ-5D displayed greater improvements for SCS patients (00.39) than for improved CMM patients (0.01). The proportion of SCS patients using medication fell substantially, particularly for opioids (−49%). In the statistical model projection, compared with the CMM group at year 5, the SCS group showed an incremental cost of € 15,406 for an incremental gain of 0.56 0.56 QALYs, for an ICER of € 27,330, below the €30,000 willingness-to-pay threshold for Spain. SCS had a 79% of probability of being cost-effective. Conclusion SCS is a cost-effective treatment for FBSS compared to CMM alone based on real-world evidence.

show abstract

Section: Discussionmentioning

confidence: 99%

“…As drug use in FBSS patients has increasingly become a concern, 8 it is significant that the proportion of the SCS +CMM group using opioids to manage pain dropped to 30.77%. The corresponding decrease in anticonvulsant use to 23.08% in the SCS+CMM group is consistent with the Also, due to the number of professionals working together, pain unit management might result in an increase of effectiveness of therapy for FBSS patients as, regardless of the treatment option, a multidisciplinary approach is recommended.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Real-World Cost-Effectiveness Analysis of Spinal Cord Stimulation vs Conventional Therapy in the Management of Failed Back Surgery Syndrome

Rojo¹,

Hernández²,

Martínez³

et al. 2021

JPR

View full text Add to dashboard Cite

show abstract

“…For nonsurgical treatments, nonsteroidal anti-inflammatory drugs are the first choice, although when symptoms worsen, the use of a narcotic agent is considered. The recent widespread use of opioids have been reported to be associated with narcotic addition in patients with FBSS and this has become a serious social problem [13].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Electroacupuncture for Patients with Failed Back Surgery Syndrome: A Systematic Review and Meta-analysis

Shin¹,

Shin²,

Jeong³

et al. 2022

J Acupunct Res

View full text Add to dashboard Cite

Failed back surgery syndrome (FBSS) is a term that applies to symptoms such as persistent or recurring low back pain, paresthesia, sciatica, or numbness after spine surgery. Electroacupuncture (EA) has been reported to have excellent analgesic effects although there have been no systematic reviews on the effects of EA on FBSS. Therefore, a systematic review and meta-analysis of the effectiveness of EA on FBSS was conducted. Eight databases were searched for studies that used EA for FBSS and 7 randomized controlled trials (RCTs) were included. RCTs of EA as combination therapy for FBSS compared with conventional treatment demonstrated improvement in the level of pain, lumbar functional scale scores, and quality of life. However, meta-analysis showed that reduction in pain was not statistically significant, while evaluation of lumbar function significantly improved, although the quality of evidence in the RCTs was generally low. RCTs comparing EA alone with conventional treatment demonstrated an improved level of pain, lumbar function, and effective rate of treatment. Meta-analysis showed that pain was significantly decreased in the EA alone group compared with the control group, although the quality of evidence was low. To improve the quality of evidence, high-quality RCTs are required in the future.

show abstract

“…Despite the evolving surgical technologies and biologic advancements, failed spinal fusion due to pseudarthrosis remains a feared complication with rates ranging between 5% and 35%, 1–25 leading to persistent postoperative pain, and accounting for 45% to 65% of revision surgeries 2…”

mentioning

confidence: 99%

Pseudarthrosis Following Lumbar and Lumbosacral Fusion Using the Antepsoas Technique

Tannoury

Bhale

Vora

et al. 2021

Spine

View full text Add to dashboard Cite

Study Design. Retrospective case-control study.Objective. The aim of this study was to evaluate the prevalence of pseudarthrosis following antepsoas (ATP) lumbar and lumbosacral fusions. Summary of Background Data. Pseudarthrosis is a feared complication following spinal fusions and may affect their clinical outcomes. To date there are no sufficient data on the fusion rate following ATP lumbar and lumbosacral arthrodesis. Methods. This is a retrospective review of 220 patients who underwent lumbar minimally invasive antepsoas (MIS-ATP) fusions between January 2008 and February 2019 who have at least 1-year postoperative computed tomography (CT) follow-up scans. Fusion was graded using CT scans imaging and adopting a 1-4 grading scale (1, definitely fused; 2, likely fused; 3, likely not fused; 4, definitely not fused/nonunion). Grades 3 or 4 indicate pseudarthrosis. Results. A total of 220 patients (average age: 66 years, 82 males (37.2%), and 127 (57.7%) smokers) were included. Eight patients (3.6%) developed pseudarthrosis. A total of 693 discs were addressed using the ATP approach. Of those, 681 (98.3%) were considered fused (641 levels [92.5%] were ''definitely fused'' and 40 levels [5.8%] were ''Likely fused'') and 12 discs (1.7%) developed pseudarthrosis (seven levels [1.0%] were ''likely not fused'' and five levels (0.7%) were ''definitely not fused''). The highest rate of pseudarthrosis was found at L5-S1 (4.8%) compared to the L1-L5 discs (0-2%). Of 127 smokers, six developed pseudarthrosis (odds ratio ¼ 2.3, P ¼ 0.3). The fusion rates were 95.3% and 97.8% for smokers and nonsmokers, respectively. Of the eight patients who developed pseudarthrosis, only four (50%) were symptomatic, of whom two (25%) required revision surgery. Both of these patients were smokers. The overall revision rate due to pseudarthrosis was 0.9% (two of 220 patients). Conclusion. The MIS-ATP technique results in a high fusion rate (96.4% of patients; 98.3% of levels). Pseudarthrosis was noted mostly at the L5-S1 discs and in smokers.

show abstract

Narcotic Addiction in Failed Back Surgery Syndrome

Cited by 12 publications

References 72 publications

Real-World Cost-Effectiveness Analysis of Spinal Cord Stimulation vs Conventional Therapy in the Management of Failed Back Surgery Syndrome

Real-World Cost-Effectiveness Analysis of Spinal Cord Stimulation vs Conventional Therapy in the Management of Failed Back Surgery Syndrome

Effectiveness of Electroacupuncture for Patients with Failed Back Surgery Syndrome: A Systematic Review and Meta-analysis

Pseudarthrosis Following Lumbar and Lumbosacral Fusion Using the Antepsoas Technique

Contact Info

Product

Resources

About