Title
Percutaneously implanted plates in failed back surgery syndrome (FBSS) Percutaneously implanted plates in failed back surgery syndrome (FBSS)
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
Oxford ,
Subject
Human medicine
Source (journal)
Neuromodulation. - Oxford
Volume/pages
14(2011) :4 , p. 319-324
ISSN
1094-7159
ISI
000293562500011
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
Objective:  To evaluate the clinical efficacy of pain suppression in back area and lower extremities by recently developed plate electrodes for spinal cord stimulation through percutaneous access. Methods:  A retrospective analysis is performed: 20 consecutive patients with both lower extremity pain and low back pain, with low back counting for at least 30% of the overall pain were implanted with a small profile plate type lead, S-Series (SJM), via percutaneous approach. Patients were asked to rate their back and leg pain as well as their overall satisfaction and data on quality of life (QOL) on a (010 point) visual analog scale (VAS) before and after implantation. Medication use, functional pain (pain when bending forward, moving), and patient satisfaction scores also were collected. Results:  A significant reduction of 55% and 45.7% in, respectively, VAS legs and VAS back pain was found. One year postoperatively the reduction was still present, respectively, 43% and 27% for the legs and the back. In 17 patients (85%) a clinically relevant reduction (defined as reduction of 2 points or 30% in VAS) in back pain was seen, with a mean decrease of 4.3 points (2.010.0) or 52% (22100). Only three patients had no reduction in back pain, although they had reduction of their pain in the lower extremities. A significant and clinically relevant improvement of 66% and 70% was seen, respectively, for general satisfaction and QOL, respectively. One year postoperatively this improvement was still present, respectively, 69% and 75% for the satisfaction and QOL. Importantly functional pain also decreased by 51%. No infections occurred. Mean duration of post-op wound pain was 13.5 hours. Conclusion:  Percutaneous implantation of the S-Series plate electrodes using a 10 gauge epidural needle combines the advantages of a minimal invasive technique with the possibility to cover the back area supplementing leg coverage in 85% of the failed back surgery syndrome patients.
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