LONG-TERM PAIN RELIEF DURING SPINAL-CORD STIMULATION - THE EFFECT OF PATIENT SELECTION

We reviewed our experience with spinal cord stimulation (SCS) in treat ing 116 patients with pain in one or both legs. All these patients wer e selected for an initial week of trial stimulation by the criteria: p ain due to a known benign organic cause, failure of conventional pain control methods and absence of major personality disorders. Selected p atients included 78 with the Failed Back Surgery Syndrome (FBSS), in w hom proven correlation existed between the clinical picture and the ne uroradiological and electromyogram abnormalities. Eighty-four out of 1 16 selected patients underwent definitive SCS implantation after 1 wee k of trial stimulation with excellent results (more than 75% pain reli ef). They were followed clinically every 3 months for a mean follow-up period of 47 months. Forty-five patients (54%) continued to experienc e at least 50% of pain relief at the latest follow up. Seventy-seven p atients (91%) were able to reduce their medication intake and 50 patie nts (60%) reported an improvement in lifestyle. FBSS patients responde d more positively to the trial stimulation than the other patients. Ho wever, the later outcome was not affected by patient selection as long -term benefit was similar in all definitive SCS patients irrespective of aetiology.