Effect of Multicolumn Lead Spinal Cord Stimulation on Low Back Pain in Failed Back Surgery Patients: A Three-Year Follow-Up

Abstract

Objectives: Spinal cord stimulation (SCS) remains poorly efficient at reducing back pain in failed back surgery syndrome (FBSS) patients. We aimed at determining whether a new multicolumn lead SCS technique was efficient at durably reducing their leg (LP) and back (BP) pain.

Materials and methods: Sixty-two consecutive refractory FBSS patients received multicolumn SCS. Visual analogue scale (VAS) self-evaluation of BP, LP, and limitation of daily activity (LAD) were recorded preoperatively and at 2, 6, 12, 24, and 36 months after surgery. Quality of sleep and use of concomitant medications were also recorded.

Results: Complete datasets were obtained in 29 patients. BP (median VAS [25-75 centiles]) significantly decreased from 9 (8.5-10) preoperatively, to 3 (3-4) at short-term follow-up (2 months), and rose up to 5 (4-5) at 36 months. LP evolved from 7 (6-8) preoperatively, to 2.5 (2-3) at short-term follow-up, and 3 (2-3) at 36 months. Correspondingly, LAD VAS was 8 (8-9) preoperatively, and decreased to stable values of 3 (3-4) during the follow-up period. Quality of sleep also improved, with 72% of patients reporting poor sleep preoperatively to 0-7% in the follow-up period until 36 months. The percentages of patients regularly taking analgesic and/or co-analgesic medications decreased from 100% preoperatively to 8, 4, 12, 19, and 19%.

Conclusion: Multicolumn lead SCS in FBSS patients significantly improve BP, LP, quality of life, and medication consumption for at least 36 months. A classical placebo effect cannot account for long-term improvements of such magnitude.

Keywords: Back pain; failed back surgery syndrome; multicolumn lead; spinal cord stimulation.