gms | German Medical Science

Objective: Chronic low back pain is a widespread disease for which there are many treatment options. The implantation of a Spinal Cord Stimulation (SCS)-system in patients with refractory back pain, especially in post-discectomy syndrome, is widely used. SCS is not a mainstay therapy in the so-called “virgin-back” patients who had no prior surgery while having refractory low back pain without any other (operative) treatment indication. The aim of this study is to present the first follow-up results of the SCS therapy on “virgin-back” patients.

Methods: Six patients (all female) with chronic refractory back pain and no prior operation with a pain duration of 7.9 years (sd ± 3,5) and average age of 66 years (55-81) were treated with SCS systems in different variations (3 patients with two eight-contact electrodes, 1 patient with one twelve-contact-electrode, 1 patient with two 16-contact electrode and 1 patient with one 16 contact electrode). The pain intensity was documented using the numerical rating scale (NRS; 0: no pain, 10: extremely severe pain) preoperatively and in the trial phase as well as in a 3-and 6 month- follow-up.

Results: The preoperative mean NRS was 8.0 (7-9), during the trial it was 2.0 (0-3.5). In the 3-month follow-up, the mean NRS was 2.5/10 (1-3), the same in the 6-months-follow-up, which corresponds to an average reduction in pain intensity of 71.5%. There were no major complications during this time.

Conclusion: There are only a few publications on SCS therapy for “virgin-back” patients. Our patient collective confirms the positive effect of SCS with different companies and stimulation paradigms in so-called “virgin-back” patients. Further observations and studies with larger patient groups are required to optimize the stimulation with patient-tailored paradigms.