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60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit den Benelux-Ländern und Bulgarien

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

24. - 27.05.2009, Münster

Constant current, variable voltage spinal cord stimulator (SCS) for therapy of patients with failed back surgery syndrome (FBSS)

Meeting Abstract

  • M. Klingenhöfer - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf
  • S. Schu - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf
  • J. Vesper - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf
  • H.-J. Steiger - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocMI.04-03

DOI: 10.3205/09dgnc185, URN: urn:nbn:de:0183-09dgnc1857

Veröffentlicht: 20. Mai 2009

© 2009 Klingenhöfer et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Out of the total of all patients that underwent spinal surgery the incidence of failed back surgery syndrome is 40%. The aim of the study was to evaluate prospectively the efficacy and patients activities of daily living and quality of life using a special spinal cord stimulator to treat this syndrome.

Methods: In this prospective single center trial 56 patients with failed back surgery syndrome were included. Patients signed informant consent for the study. An independent third party interviewed all patients who underwent spinal cord stimulator implantation preoperatively and at follow-up with intervals of 1 week, 3 month and 1 year respectively. Prior to implantation of the stimulator a short test phase of three to five days was performed in order to ensure the effect. Pain was assessed by means of a 10 point visual analog scale (VAS). Only patient’s who reported at least 50% pain relief during the trial were considered to be candidates for the device implantation. Activities of daily living were assessed with the PROLO scale, including functional and social items. Quality of life was examined with a simple questionnaire, which was handed out to the patients. Medication was evaluated in the follow-up. Complications, side effects and clinical outcome were documented.

Results: Both lower back and sciatic pain decreased significantly, mean VAS 9 preoperatively to 4 at 1 y follow-up, (p<0.05). There was no significant loss of neurological function in the PROLO scale. Social function was also unchanged. The mean improvement of quality of life was 24%. 7 patients did not profit from electrode implantation and therefore were not implanted with final stimulator. There was no significant change in medical pain treatment. Unfortunately 12 patients suffered from early or delayed infection resulting in surgical revisions. All patients were scheduled for a new device after three months. We therefore introduced continuous antibiotic administration for the first 5 postoperative days.

Conclusions: Spinal cord stimulation improves lumbar pain in patients with FBSS. Prevention of infections is required by perioperative antibiotic administration. Further studies will be performed to analyze the multifactor social and neurological outcome of the patients.