Attrition with spinal cord stimulation

Mann, S.A. and Sparkes, E. and Duarte, R.V. and Raphael, J.H. (2015) Attrition with spinal cord stimulation. British Journal of Neurosurgery, 29 (6). pp. 823-828. ISSN 02688697 (ISSN)

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Abstract

The aim of this prospective study was to investigate whether spinal cord stimulation (SCS) significantly reduces pain intensity for up to 18-month follow-up in patients with chronic neuropathic pain. Forty-eight patients were recruited. Patients rated their pain using a Visual analog scale (VAS) and pain-related disability using the Oswestry Disability Index (ODI) at baseline (1 week prior to SCS surgery) and at 6-, 12-, and 18-month follow-up. Pain intensity significantly decreased from baseline to all 3 time points [F (3,135) = 16.264, p < 0.001]. The greatest difference in the reduction of pain intensity was observed between baseline (M = 7.20, SD = 1.34) and 6-month follow-up (M = 4.60, SD = 2.20), [t(47) = 6.741, p < 0.001]. However, when looking at differences between the 6-month follow-up and subsequent assessments, statistically significant increases in pain intensity from the 6-month to the 12-month follow-up [t(47) = -2.788, p = 0.008], and from the 6-month to the 18-month follow-up [t(47) = -3.339, p = 0.002] could be observed. Statistically significant changes were also observed for clinical changes in pain scores [F (2,94) = 4.972, p = 0.009. There was a significant decrease in the percentage of clinical change obtained from the 6-month (M = 33.19, SD = 35.63) to the 12-month follow-up (M = 23.76, SD = 33.62), [t(47) = 2.347, p = 0.025], and from the 6-month to the 18-month follow-up (M = 18.34, SD = 33.51), [t(47) = 3.072, p = 0.004]. A number of patients also reported higher levels of pain intensity at the 12-and 18-month follow-up than at baseline.Pain-related disability scores significantly decreased from baseline (M = 55.04, SD = 16.43) to the 6-month follow up (M = 46.98, SD = 19.05), [t(47) = 3.464, p = 0.001] and from baseline to the 12-month follow up (M = 48.49, SD = 20.94), [t(47) = 2.918, p = 0.005], but not during the 18-month follow up (M = 51.75, SD = 20.92), [t(47) = 1.330, p =.190]. There was a significant increase in pain-related disability between the 6- and the 18-month follow up [t(47) = -2.188. p = 0.034]. These findings suggest that the beneficial effect of SCS on pain intensity may diminish over time, and that the 6-month follow-up scores may reflect a placebo effect. © 2015 The Neurosurgical Foundation.

Item Type: Article
Uncontrolled Keywords: attrition, chronic pain, clinical efficacy, neuropathic pain, spinal cord stimulation
Subjects: B100 Anatomy, Physiology and Pathology
Divisions: Faculty of Health, Education and Life Sciences > Centre for Social Care, Health and Related Research (C-SHARR) > Health Sciences
Faculty of Health, Education and Life Sciences > School of Health Sciences
Depositing User: Miss Jessica Baylis
Date Deposited: 03 Jan 2017 13:45
Last Modified: 03 Jan 2017 13:45
URI: http://www.open-access.bcu.ac.uk/id/eprint/569

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