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Improving Spinal Cord Stimulators’ Outcomes: A literature Review

Volume 1 | Issue 1 | October 2020-March 2021 | page: 33-36 | Gina Kelly-Vasquez


Authors: Gina Kelly-Vasquez [1]

[1] University of North Florida, 1 UNF Drive, Jacksonville, FL 32224

Address of Correspondence
Dr. Gina Kelly-Vasquez,
University of North Florida,1 UNF Drive, Jacksonville, FL 32224
E-mail: Animig@gmail.com


Abstract


Spinal pain is debilitating, inhibits the quality of life, requires many interventions that include non-pharmacological, pharmacological therapies that are costly to both patients and insurance companies. With the advent of updated chronic pain treatment technology, it is essential to accurately assess risks versus benefits and many varying contributing factors in treatment candidacy.
The purpose of the exploratory research is to describe current pain neuromodulation technology that includes spinal cord stimulators (SCS) and dorsal root ganglion (DRG) technology. The employed research methods are secondary research analysis comprised quantitative and qualitative data.
The research revealed that when individuals undergoing the SCS trial period, if they experienced 4.6 out of ten pains, there is a 50% probability of permanent implantation success with a sensitivity of 97.14 and specificity of 44.44%. An individual who underwent DRG implantation within 1-year, complex regional pain, and failed back syndrome was reduced by −56.7%, back pain was −46.71%, and foot pain −72.97%. In one reviewed study conducted from 1997 to 2014, 73% of permanent devices were removed due to inadequate pain control. In another reviewed research conducted from 2013 to 2017, 22% reported complications causing a need for device removal.
It is concluded that although there is a trial period for the candidacy of permanent placement of SCS or DRG, there is a high incidence of permanent device explanation. There is a need for more exploratory research on causative variables that result in permanent neuromodulation device removal. Thorough documenting of baseline pain, along with thorough psychological clearance, can aid in providing enhanced outcomes after permanent implantation.
Keywords: Spinal cord stimulators, implants, generators, explantation, revisions.

 


References

1. Sayed D, Kallewaard JW, Rotte A, Jameson J, Caraway D. Pain relief and improvement in quality of life with 10 kHz SCS therapy: Summary of clinical evidence. CNS Neurosci Ther 2020;26:403-15.
2. Hoelscher C, Riley J, Sharan A, Wu C. Cost-effectiveness data regarding spinal cord stimulation for low back pain. Spine (Phila Pa 1976) 2017;42:S72-9.
3. Orhurhu V, Chu R, Orhurhu MS, Odonkor CA. Association between pain scores and successful spinal cord stimulator implantation. Neuromodulation 2019;23:660-6.
4. Sdrulla AD, Guan Y, Raja SN. Spinal cord stimulation: Clinical efficacy and potential mechanisms. Pain Pract 2018;18:1048-67.
5. Haider SA, Wilock ME, Pilitsis JG. Complication avoidance and revision surgery. In: Mammis A, editor. Spinal Cord Stimulation Principles and Practice. Hauppauge: Nova Science Publishers Inc.; 2016. p. 95-110. Available from: http://www.search.ebscohost.com.dax.lib.unf.edu/login.aspx?direct=true&db=nlebk&an=1164744&site=eds-live&scope=site.
6. Kaufman A, Shah R. Indications and patient selection. In: Mammis A, editor. Spinal Cord Stimulation Principles and Practice. Hauppauge: Nova Science Publishers Inc.; 2016. p. 8-12. Available from: http://www.search.ebscohost.com.dax.lib.unf.edu/login.aspx?direct=true&db=nlebk&an=1164744&site=eds-live&scope=site.
7. Anderson B, Cockroft KM. Spinal Cord Stimulation. Rolling Meadows: American Association of Neurological Surgeons; 2020. Available from: https://www.aans.org/patients/neurosurgical-conditions-and-treatments/spinal-cord-stimulation. [Last accessed on 2020 Apr 05].
8. Malige A, Sokunbi G. Spinal cord stimulators: A comparison of the trial period versus permanent outcomes. Spine (Phila Pa 1976) 2019;44:E687-92.
9. Springston GM. Spinal cord stimulators-the basics and the buzz. J Nurse Life Care Plan 2019;19:29-35. Available from: http://www.search.ebscohost.com.dax.lib.unf.edu/login.aspx?direct=true&db=rzh&an=138528281&site=eds-live&scope=site.
10. Verrills P, Sinclair C, Barnard A. A review of spinal cord stimulation systems for chronic pain. J Pain Res 2016;9:481-92.
11. Woolstenhulme C. Spinal cord stimulator coding. J Nurse Life Care Plan 2019;19:36-7. Available from: http://www.search.ebscohost.com.dax.lib.unf.edu/login.aspx?direct=true&db=rzh&an=138528282&site=eds-live&scope=site.
12. Dupre DA, Tomycz N, Whiting D, Oh M. Spinal cord stimulator explantation: Motives for removal of surgically placed paddle systems. Pain Pract 2018;18:500-4.


How to Cite this Article: Vasquez GK| Improving Spinal Cord Stimulators’ Outcomes: A literature Review| Back Bone: The Spine Journal | October 2020-March 2021; 1(1): 33-36.

 


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