Spinal Cord Stimulation for Fail Back Surgery Syndrome: Literature Review and Clinical Study

Abstract

Objective: Fail back surgery syndrome (FBSS) is a common cause of pain following spine surgery, and is associated with persistent or recurrent pain despite anatomically correct intervention. Spinal cord stimulation (SCS) is regarded as one of the most effective methods of treatment for fail back surgery syndrome. Methods: We studied 34 patients who underwent test stimulation and chronic SCS for FBSS. Results: Six months postoperatively, mean improvement by the visual analog scale (VAS) of average and maximum daily pain, and the painDETECT score, were 54.4%, 50.7% and 57.3%, respectively. This meets the criteria for effectiveness of the method, according to the literature. Most of patients reported significant improvements in life quality and less need for analgesics. Complications were seen in nine patients (26.4%) and included: intraoperative dura injury (one patient, 2.9%), wound infection (one patient, 2.9%), and electrode displacement (seven patients, 20.5%). No cases of postoperative neurological deterioration were seen. Conclusions: SCS is safe and effective for the treatment of neuropathic pain caused by FBSS. Level of Evidence IV; Case series.

Failed Back Surgery Syndrome: No Longer a Surgeon’s Defeat—A Narrative Review

“…One such therapy is dorsal root ganglion (DRG) stimulation, which has shown promising results in small studies [ 108 ]. Another therapy is peripheral nerve stimulation (PNS), which has been used to treat PSPS-T1/2 with mixed results [ 109 ]. Additionally, motor cortex stimulation (MCS) has been investigated as a treatment option, but the evidence for its effectiveness is limited [ 110 ].…”