SPINAL-CORD STIMULATION - A VALUABLE TREATMENT FOR CHRONIC FAILED BACK SURGERY PATIENTS

Spinal cord stimulation (SCS) has been used in the treatment of ''chro nic failed back surgery syndrome'' for many years. To evaluate long-te rm results and cost effectiveness of SCS, we interviewed 69 patients t reated during a period of 13 years. Twenty-six patients stopped using SCS; there was no clear explanation for this unsatisfactory result in 10. Forty-three patients continued with the therapy and obtained good pain relief Electrode breakage either spontaneous or due to a procedur e to obtain better stimulation paresthesias was more frequent in the r adiofrequency-coupled system group than in the battery group (mean +/- SEM 2.81 +/- 2.0 versus 1.42 +/- 1.51, respectively; P = 0.0018). Ten patients obtained better pain relief than during the trial procedure. Some still need opioid analgesics, but 11 of the 16 who require these drugs obtained a synergistic effect when concomitantly using the stim ulator Eleven patients have returned to work. In our center; the appli cation of Scs costs on average $3660 per patient per year. Although th is seems expensive, it may be a cost-effective treatment if other ther apies fail. (C) U.S. Cancer Pain Relief Committee, 1997.