Spinal Cord Stimulation vs. Conventional Medical Management: A Prospective, Randomized, Controlled, Multicenter Study of Patients with Failed Back Surgery Syndrome (PROCESS Study)

Kumar, Krishna; North, Richard B.; Taylor, Rod S; Sculpher, Mark; Abeele, Carine Van den; Gehring, Marta; Jacques, Line; Eldabe, Sam; Meglio, Mario; Molet, J.; Thomson, Simon; O’Callaghan, J.R.; Eisenberg, Elon; Milbouw, G; Fortini, Gianpaolo; Richardson, Jonathan; Buchser, Eric; Tracey, Sherri; Reny, Pascale; Brookes, Morag; Sabene, Salvatore; Cano, P.; Banks, Carol; Pengelly, L. D.; Adler, Rivka; Leruth, Sophie; Kelly, Claire; Jacobs, Myriam

doi:10.1111/j.1525-1403.2005.00027.x

Cited by 164 publications

(135 citation statements)

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“…One RCT was a crossover study, 23 so only the period up to the first crossover was included in the analysis. Another RCT was published as a protocol 24 and as a conference abstract, 25 but the updated search identified an article with 6 months data. 26 For case series, data from after the intervention only, or before and after data together with difference data or results as described by the authors, were presented.…”

Section: Methods Of the Reviewmentioning

confidence: 99%

Systematic Review of the (Cost-)effectiveness of Spinal Cord Stimulation for People With Failed Back Surgery Syndrome

Bała

Riemsma

Nixon

et al. 2008

The Clinical Journal of Pain

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For the effectiveness analysis, 1 fully published randomized controlled trial, one randomized controlled trial with 6 month results (both of moderate quality), 1 retrospective cohort study, and 13 case series (all of low quality) were included. The mean period of follow-up was between 6 months and 8.8 years. These studies show that SCS is effective in the treatment of FBSS in terms of pain reduction. The effect was consistent in all analyzed studies. Improvements were also reported for other outcomes, such as quality of life and functional status. All the studies reported some complications, most of which were technical problems. In terms of cost-effectiveness, 3 studies met the inclusion criteria and offered the same conclusion that SCS is both more effective and less costly in the long-term, but there is an initial high cost associated with device implantation and maintenance.

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Section: Methods Of the Reviewmentioning

confidence: 99%

Systematic Review of the (Cost-)effectiveness of Spinal Cord Stimulation for People With Failed Back Surgery Syndrome

Bała

Riemsma

Nixon

et al. 2008

The Clinical Journal of Pain

View full text Add to dashboard Cite

show abstract

“…The mechanism of action is based on the gate theory by Wall and Melzack but the exact mechanisms are still under study [32,33]. Many studies have demonstrated the efficacy and health-economic value of spinal cord stimulation (SCS) for chronic neuropathic radicular pain over recent decades [6,7,31,[34][35][36][37][38]. However, the back pain component of FBSS remains a challenge for neurostimulation [37].…”

Section: So What Can We Do?mentioning

confidence: 99%

Failed back surgery syndrome: Who has failed?

et al. 2015

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“…Clinical complications were uncommon and mild, in general resolved by removing the device. General infection rate was 3.4% 59,61 . Evidences of cases with positive results were found in CRPS II, peripheral nerve injury, diabetic neuropathy, postherpetic neuralgia, peripheral brachial plexus injuries, amputation (stump and phantom limb pain) and partial spinal cord injury.…”

Section: Spinal Cord Electrical Stimulation (Sces)mentioning

confidence: 94%

“…New generation electrodes and neurostimulators already allow the use of MRI in patients with such implants 57,58 . The technique was initially based on spinal cord gate theory for providing preferential stimulation of large and myelinated fibers which in theory would inhibit spinal cord nociceptive afferents 59 . However, experimental studies have excluded this analgesic action mechanism on SCS involving the effect of inhibitory and modulatory spinal cord posterior horn neurotransmitters, in addition to mobilization of posterior spinal ascending pathways to pain-inhibiting brain centers.…”

Section: Spinal Cord Electrical Stimulation (Sces)mentioning

confidence: 99%

“…Recently, there has been major advance in implantable devices with the acquisition of new technologies both for electrodes and pulse generators. Although not having final studies using these new technologies, their availability for physicians and patients is a promising land where in the near future we shall have better results and lower complication rates for this therapy 59 .…”

Section: Spinal Cord Electrical Stimulation (Sces)mentioning

confidence: 99%

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Invasive treatment to control neuropathic pain

Júnior¹,

Correa

Ferreira

2016

Revista Dor

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BACKGROUND AND OBJECTIVES: Distress, allied to neuropathic pain persistence and its refractory nature, often leads patients to accept invasive procedures. Neuropathic pain control is a major medical challenge requiring approaches and decisions especially based on effectiveness, risks and costs. This study aimed at reviewing these aspects related to major invasive procedures. CONTENTS: Major invasive procedures to control neuropathic pain are presented. Initially, classically reversible anesthetic blocks; then invasive neuromodulation techniques using electric current application and the magnetic field generated by it becomes a target to be stimulated, inhibited or modified in the nervous system (central, peripheral or autonomic); and, finally, ablative procedures including anesthetic methods administering neurolytic agents rather than anesthetics and neurosurgeries using different methods to injure the nervous system to control painful neuropathic discomfort. CONCLUSION: Patients eligible to invasive procedures to control neuropathic pain have, in addition to pain itself, a mixed distress including the collection of repeated delusions at every treatment failure. They have reserved prognosis with regard to total cure and, unfortunately, relieve obtained with invasive treatment in general does not reach persistent and high rates. In such adverse situation, these partial results of decreasing original pain intensity may be interpreted as acceptable, provided the impact on final quality of life is positive. Maybe, the rare exceptions are good results obtained with typical idiopathic/cryptogenic neuralgias ironically excluded from the stricter interpretation of the new pathophysiologic classification of neuropathic pains. Keywords: Anesthetic blocks, Cordectomy, Cortical electrical stimulation, Deep electrical brain stimulation, DREZotomy, Invasive neuromodulation, Medullary electrical stimulation, Neurolytic blocks, Neuropathic pain, Neurosurgery for neuropathic pain, Spinal drugs RESUMO JUSTFICATIVA E OBJETIVOS: O sofrimento aliado à persistência e refratariedade da dor neuropática frequentemente leva seu portador a aceitar tratamentos invasivos. O controle da dor neuropática representa um desafio médico importante necessitando adoção de condutas e decisões baseadas, principalmente, em efetividade, riscos e custos. O escopo deste estudo foi a revisão desses aspectos relacionados aos principais procedimentos invasivos CONTEÚDO: São apresentados os principais procedimentos invasivos utilizados para o controle da dor neuropática. Inicialmente, os bloqueios anestésicos, classicamente reversíveis; depois as técnicas de neuromodulação invasiva que utilizam a aplicação de corrente elétrica e o campo magnético por ela gerado em alvos a serem estimulados, inibidos ou modificados, no sistema nervoso (central, periférico ou autônomo); e, finalmente, os procedimentos ablativos que incluem os métodos anestésicos que administram agentes neurolíticos ao invés de anestésicos, e, as neurocirurgias que utilizam métodos dive...

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Spinal Cord Stimulation vs. Conventional Medical Management: A Prospective, Randomized, Controlled, Multicenter Study of Patients with Failed Back Surgery Syndrome (PROCESS Study)

Cited by 164 publications

References 24 publications

Systematic Review of the (Cost-)effectiveness of Spinal Cord Stimulation for People With Failed Back Surgery Syndrome

Systematic Review of the (Cost-)effectiveness of Spinal Cord Stimulation for People With Failed Back Surgery Syndrome

Failed back surgery syndrome: Who has failed?

Invasive treatment to control neuropathic pain

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