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Clinical Evidence for Spinal Cord Stimulation for Failed Back Surgery Syndrome (FBSS): Systematic Review

Kapural, Leonardo MD, PhD*; Peterson, Erika MD; Provenzano, David A. MD; Staats, Peter MD, MBA§

doi: 10.1097/BRS.0000000000002213
Focus Issue Articles

Study Design. A systematic review.

Objective. A systematic literature review of the clinical data from prospective studies was undertaken to assess the efficacy of spinal cord stimulation (SCS) in the treatment of failed back surgery syndrome (FBSS) in adults.

Summary of Background Data. For patients with unrelenting back pain due to mechanical instability of the spine, degenerative disc disease, spinal injury, or deformity, spinal surgery is a well-accepted treatment option; however, even after surgical intervention, many patients continue to experience chronic back pain that can be notoriously difficult to treat. Clinical evidence suggests that for patients with FBSS, repeated surgery will not likely offer relief. Additionally, evidence suggests long-term use of opioid pain medications is not effective in this population, likely presents additional complications, and requires strict management.

Methods. A systematic literature review was performed using several bibliographic databases, prospective studies in adults using SCS for FBSS were included.

Results and Conclusion. SCS has been shown to be a safe and efficacious treatment for this patient population. Recent technological developments in SCS offer even greater pain relief to patients’ refractory to other treatment options, allowing patients to regain functionality and improve their quality of life with significant reductions in pain.

Level of Evidence: N/A

*Carolinas Pain Institute, Winston-Salem, NC

University of Arkansas for Medical Sciences, Little Rock, AR

Pain Diagnostics and Interventional Care, Sewickley, PA

§Premier Pain Centers, Shrewsbury, NJ.

Address correspondence and reprint requests to Leonardo Kapural, MD, PhD, Carolina's Pain Institute, Winston Salem, NC 27103; E-mail:

Received 6 December, 2016

Revised 28 February, 2017

Accepted 22 March, 2017

The manuscript submitted does not contain information about medical device(s)/drug(s).

Relevant financial activities outside the submitted work: grants, travel/accommodations/meeting expenses.

No funds were received in support of this work.

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