Long-Term Effect of Peripheral Nerve Field Stimulation as Add-On Therapy to Spinal Cord Stimulation to Treat Low Back Pain in Failed Back Surgery Syndrome Patients: A 12-Month Follow-Up of a Randomized Controlled Study

Eric-Jan J A A van Gorp*, Onno Teernstra, Hans J Aukes, Tanja Hamm-Faber, Katja Bürger, Jan Willem Kallewaard, Geert Spincemaille, Johannes W L C Schapendonk, Leon Vonhögen, Ewald Bronkhorst, Kris C P Vissers

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Web of Science)

Abstract

OBJECTIVE: Different approaches in neuromodulation have been used to treat chronic low back pain in failed back surgery syndrome (FBSS) patients. We previously randomized 52 FBSS patients to be treated with spinal cord stimulation (SCS) and additional peripheral nerve field stimulation (PNFS) or SCS alone. At three months, we found a significant reduction of back pain in the PNFS-SCS group compared to the SCS group. In the subsequent open phase part of the study, all patients received optimal SCS and PNFS simultaneously. Here, we present the 12-month follow-up data on back and leg pain.

MATERIALS AND METHODS: Data regarding back and leg pain, function, quality of life, patient satisfaction, anxiety and depression, and use of medication were collected by analyzing patients' questionnaires at 12 months and compared with data collected at baseline. Data were analyzed using multilevel regression models.

RESULTS: A combined group of 50 subjects completed the 12-month follow-up. Back pain, measured on a 100-mm visual analog scale (VAS), significantly decreased over this period by 30.0 mm (95% CI: [-37.7/-22.4]; p < 0.001), while leg pain decreased by 43.7 mm (95% CI: [-51.5/-36.2]; p < 0.001). We observed statistically significant improvement in almost all secondary outcome measurements.

CONCLUSIONS: At 12-month follow-up, PNFS in addition to SCS continues to provide a statistically significant and clinically relevant relief of low back pain in FBSS patients in whom SCS alone is effective for relief of leg pain only.

Original languageEnglish
Pages (from-to)970-977
Number of pages8
JournalNeuromodulation
Volume22
Issue number8
DOIs
Publication statusPublished - Dec 2019

Keywords

  • 10-KHZ HIGH-FREQUENCY
  • ACTIVATION
  • ADDITIONAL THERAPY
  • CONTROLLED-TRIAL
  • COST-EFFECTIVENESS
  • Chronic low back pain
  • DISABILITY
  • LEG PAIN
  • MULTICENTER
  • NEUROPATHIC PAIN
  • SUBCUTANEOUS STIMULATION
  • failed back surgery syndrome
  • peripheral nerve field stimulation
  • spinal cord stimulation
  • subcutaneous stimulation
  • MANAGEMENT
  • SCALE
  • LEAD

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