Spinal cord stimulation for patients with failed back surgery syndrome or complex regional pain syndrome: A systematic review of effectiveness and complications

Judith A. Turner, John D. Loeser, Richard (Rick) Deyo, Stacy B. Sanders

Research output: Contribution to journalArticle

342 Citations (Scopus)

Abstract

We conducted a systematic review of the literature on the effectiveness of spinal cord stimulation (SCS) in relieving pain and improving functioning for patients with failed back surgery syndrome and complex regional pain syndrome (CRPS). We also reviewed SCS complications. Literature searches yielded 583 articles, of which seven met the inclusion criteria for the review of SCS effectiveness, and 15 others met the criteria only for the review of SCS complications. Two authors independently extracted data from each article, and then resolved discrepancies by discussion. We identified only one randomized trial, which found that physical therapy (PT) plus SCS, compared with PT alone, had a statistically significant but clinically modest effect at 6 and 12 months in relieving pain among patients with CRPS. Similarly, six other studies of much lower methodological quality suggest mild to moderate improvement in pain with SCS. Pain relief with SCS appears to decrease over time. The one randomized trial suggested no benefits of SCS in improving patient functioning. Although life-threatening complications with SCS are rare, other adverse events are frequent. On average, 34% of patients who received a stimulator had an adverse occurrence. We conclude with suggestions for methodologically stronger studies to provide more definitive data regarding the effectiveness of SCS in relieving pain and improving functioning, short- and long-term, among patients with chronic pain syndromes.

Original languageEnglish (US)
Pages (from-to)137-147
Number of pages11
JournalPain
Volume108
Issue number1
DOIs
StatePublished - Mar 2004
Externally publishedYes

Fingerprint

Failed Back Surgery Syndrome
Complex Regional Pain Syndromes
Spinal Cord Stimulation
Pain
Chronic Pain

Keywords

  • Complex regional pain syndrome
  • Failed back surgery syndrome
  • Spinal cord stimulation
  • Systematic review

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Neurology
  • Neuroscience(all)
  • Pharmacology
  • Clinical Psychology

Cite this

Spinal cord stimulation for patients with failed back surgery syndrome or complex regional pain syndrome : A systematic review of effectiveness and complications. / Turner, Judith A.; Loeser, John D.; Deyo, Richard (Rick); Sanders, Stacy B.

In: Pain, Vol. 108, No. 1, 03.2004, p. 137-147.

Research output: Contribution to journalArticle

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