Peripheral Nerve Stimulation: A Treatment for Chronic Low Back Pain and Failed Back Surgery Syndrome?

Abstract

Objective. This study aims to evaluate the usefulness of peripheral nerve stimulation as a treatment option for patients with chronic low back pain. Materials and Methods. More than 12 months, we collected data on consecutive patients who had successful trials and were subsequently implanted with octrode percutaneous leads placed subcutaneously within the major area of pain. Eleven patients met diagnostic criteria for failed back surgery syndrome. A questionnaire assessed outcomes including: pain, analgesic use, and patient satisfaction. The response rate was 93% (13/14): average follow-up time was seven months. Results. There was a significant decrease in pain levels: an average reduction of 3.77 visual analog scale points. Eleven patients (85%) reported successful outcomes and an average pain reduction of 4.18 points but two reported a poor response. Pain relief was highly correlated with reduced analgesia and patient satisfaction. No complications were reported. Conclusion. This study demonstrates a treatment option that is safe, nonpharmacologic, reversible, and effective for patients with chronic low back pain that have exhausted other treatment options. KEY WORDS:Chronic pain, failed back surgery syndrome, low back pain, neuromodulation, neuropathic pain, peripheral nerve stimulation.

Subcutaneous Stimulation as ADD-ON Therapy to Spinal Cord Stimulation Is Effective in Treating Low Back Pain in Patients With Failed Back Surgery Syndrome: A Multicenter Randomized Controlled Trial

“…Currently, these patients may be less suitable for SCS due to lower response rates over time (11)(12)(13). Case reports regarding the use of subcutaneous stimulation alone or as add on therapy to SCS in treating low back pain reported positive outcomes (14)(15)(16)(17)(18). A feasibility study performed by our group (15) showed a statistically significant reduction of pain in the leg and the lower back after 12 months of treatment with subcutaneous stimulation as add-on therapy to spinal cord stimulation in FBSS patients.…”

Interventional Pain Management for Failed Back Surgery Syndrome

“…The mechanisms are likely similar to those of SCS . Verrills et al . demonstrated that peripheral nerve stimulation provided an average pain reduction in 3.77 visual analog points in patients with FBSS at an average follow‐up time of 7 months.…”

Peripheral Nerve Stimulation for the Treatment of Truncal Pain

“…Paicius et al [4] first reported a series of 6 patients, 5 of whom had prior lumbar surgery with all patients noting greater than 50% pain relief. Verrills et al [18] reported that among 13 consecutively implanted patients 85% noted greater than 50% pain relief with a mean follow-up period of 7 months. Although long-term data are not available, Krutsch et al [19] reported a single patient with lumbar FBSS who had 90% improvement at 12 months postimplant.…”