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8 Articles in this Series
Introduction
8% Capsaicin Patch Effective for Post-surgery and Phantom Limb Pain
Fibromyalgia Pain Reduced by Low-dose Naltrexone
Helping to Improve Pain Care in Hospice Patients
Patient Selection Key to Spinal Cord Stimulation Success
Patients at High Risk for Substance Abuse Benefit from Combined Therapy
Prolotherapy Benefits Patients With Scoliosis
Scheduled Screens Increased Compliance
Web Tool Helps Management of Neuropathic Pain

Patient Selection Key to Spinal Cord Stimulation Success

The efficacy (and success) of spinal cord stimulation is dependent on strict patient selection, according to a 5-year review of the use of spinal cord stimulation (SCS) for the treatment of chronic, nonmalignant pain. The investigators, led by Elias Veizi, MD, PhD, from the University Hospitals of Cleveland in Ohio, confirmed that SCS can provide significant long-term relief for patients with intractable pain—but the procedure is not for everyone.1

To study the success of SCS, the investigators conducted a retrospective review of 275 patients who underwent a trial of SCS between 2006 to 2011. Of the 275 patients, 189 were deemed suitable for a permanent SCS implant (>50% improvement in activity and pain). The trial-to-permanent implant ration was 68.4% for the general population. The disease-specific ratios, however, were broken down as follows: failed back surgery syndrome, 71%; complex regional pain syndrome, 64.7%; small fiber neuropathy, 80%; postherpetic neuralgia/peripheral neuropathy, 60%; visceral pain postdifferential nerve block, 80%.

Numeric rating scores showed improvement in pain, beginning at 8.5 and decreasing to 4.3 at the first month, then to 5.2 at 12 months.

SCS has long been a widely applied treatment for postlaminectomy pain, visceral pin, complex regional pain syndrome, and peripheral neuropathy.2,3 The investigators concluded that SCS can provide long-term benefits for chronic, intractable pain associated with various conditions, though exhaustive assessment of the pain quality and strict patient selection has significant effects on efficacy of SCS treatment.

References

  1. Veizi E, Hayek S. Spinal cord stimulation efficacy: review of 5 years experience from an academic center database. Pain Med. 2012;13(2):Abstract 128.
  2. Kemler MA, de Vet HC, Barendse GA, van den Wildenberg FA, van Kleef M. Spinal cord stimulation for chronic reflex sympathetic dystrophy: five-year follow-up. N Engl J Med. 2006;354(22):2394-2396.
  3. Kumar K, Taylor RS, Jacques L, et al. The effects of spinal cord stimulation in neuropathic pain are sustained: a 24-month follow-up of the prospective randomized controlled multicenter trial of the effectiveness of spinal cord stimulation. Neurosurgery. 2008;63(4):762-770.
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