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  4. Spinal cord stimulation versus conventional medical management for neuropathic pain: a multicentre randomised controlled trial in patients with failed back surgery syndrome
 
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Titre

Spinal cord stimulation versus conventional medical management for neuropathic pain: a multicentre randomised controlled trial in patients with failed back surgery syndrome

Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
PAIN  
Auteur(s)
Kumar, K.
Auteure/Auteur
Taylor, R. S.
Auteure/Auteur
Jacques, L.
Auteure/Auteur
Eldabe, S.
Auteure/Auteur
Meglio, M.
Auteure/Auteur
Molet, J.
Auteure/Auteur
Thomson, S.
Auteure/Auteur
O'Callaghan, J.
Auteure/Auteur
Eisenberg, E.
Auteure/Auteur
Milbouw, G.
Auteure/Auteur
Buchser, E.
Auteure/Auteur
Fortini, G.
Auteure/Auteur
Richardson, J.
Auteure/Auteur
North, R. B.
Auteure/Auteur
Liens vers les personnes
Buchser, Eric  
Liens vers les unités
Anesthésiologie  
ISSN
1872-6623
Statut éditorial
Publié
Date de publication
2007-11
Volume
132
Numéro
1-2
Première page
179
Dernière page/numéro d’article
88
Notes
Journal Article --- Old month value: Nov
Résumé
Patients with neuropathic pain secondary to failed back surgery syndrome (FBSS) typically experience persistent pain, disability, and reduced quality of life. We hypothesised that spinal cord stimulation (SCS) is an effective therapy in addition to conventional medical management (CMM) in this patient population. We randomised 100 FBSS patients with predominant leg pain of neuropathic radicular origin to receive spinal cord stimulation plus conventional medical management (SCS group) or conventional medical management alone (CMM group) for at least 6 months. The primary outcome was the proportion of patients achieving 50% or more pain relief in the legs. Secondary outcomes were improvement in back and leg pain, health-related quality of life, functional capacity, use of pain medication and non-drug pain treatment, level of patient satisfaction, and incidence of complications and adverse effects. Crossover after the 6-months visit was permitted, and all patients were followed up to 1 year. In the intention-to-treat analysis at 6 months, 24 SCS patients (48%) and 4 CMM patients (9%) (p<0.001) achieved the primary outcome. Compared with the CMM group, the SCS group experienced improved leg and back pain relief, quality of life, and functional capacity, as well as greater treatment satisfaction (p<or=0.05 for all comparisons). Between 6 and 12 months, 5 SCS patients crossed to CMM, and 32 CMM patients crossed to SCS. At 12 months, 27 SCS patients (32%) had experienced device-related complications. In selected patients with FBSS, SCS provides better pain relief and improves health-related quality of life and functional capacity compared with CMM alone.
PID Serval
serval:BIB_C259E3420BF0
DOI
10.1016/j.pain.2007.07.028
PMID
17845835
WOS
000251015400025
Permalien
https://iris.unil.ch/handle/iris/153937
Date de création
2008-01-28T09:41:29.592Z
Date de création dans IRIS
2025-05-20T22:45:56Z
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