UCD School of Public Health, Physiotherapy and Population Science, Health Sciences Centre, University College Dublin, Ireland.
Eur J Pain. 2012 Jul;16(6):793-802. doi: 10.1002/j.1532-2149.2011.00092.x. Epub 2011 Dec 21.
The aim of this review was to determine the impact of spinal cord stimulation (SCS) on physical function and sleep quality in individuals with failed back surgery syndrome (FBSS). This review comprised three phases: an electronic database search (PubMed, Cinahl Plus, EMBASE, PsychInfo, Pedro, Cochrane Library) identified potential papers; these were screened for inclusion criteria, with extraction of data from accepted papers and rating of internal validity by two independent reviewers using the Effective Public Health Practice Project quality assessment tool, a tool designed to assess non-RCTs (randomized controlled trials) as well as RCTs. Strength of the evidence was rated using the Agency for Health Care Policy and Research guidelines. The search generated 13 quantitative papers that fulfilled the inclusion criteria; all 13 studies investigated the impact of SCS on physical function, and nine studies investigated the impact of SCS on sleep quality. Consistent evidence (level C) found that SCS positively affected physical function, with improvements in participation in activities of daily living, leisure, social and work-related activities. Similarly, consistent evidence (level C) found improvements in sleep quality following SCS. Improvements in sleep quantity, a reduction in awakenings and a decrease in sleep medication use were also noted (level D). The impact of SCS on cognitive function, i.e., memory and concentration, was also assessed using the same search strategy, no papers fulfilled the inclusion criteria for this study. Spinal cord stimulation effectively addressed many physical function and sleep problems associated with FBSS; however, there is a need for further high-quality objective investigations to support this.
本综述的目的是确定脊髓刺激（SCS）对失败性腰椎手术综合征（FBSS）患者身体功能和睡眠质量的影响。本综述包括三个阶段：电子数据库检索（PubMed、Cinahl Plus、EMBASE、PsychInfo、Pedro、Cochrane Library）确定潜在的论文；对这些论文进行筛选，以确定是否符合纳入标准，并从被接受的论文中提取数据，由两名独立评审员使用有效公共卫生实践项目质量评估工具（一种旨在评估非随机对照试验（RCT）和 RCT 的工具）对内部有效性进行评分。证据的强度使用医疗保健政策和研究机构的指南进行评级。该检索共生成了 13 篇符合纳入标准的定量研究论文；所有 13 项研究均调查了 SCS 对身体功能的影响，9 项研究调查了 SCS 对睡眠质量的影响。一致的证据（C 级）发现 SCS 对身体功能有积极影响，可改善日常生活活动、休闲、社交和工作相关活动的参与度。同样，一致的证据（C 级）发现 SCS 后睡眠质量得到改善。还注意到睡眠质量的改善（包括睡眠时间增加、觉醒减少和睡眠药物使用减少）（D 级）。同样使用相同的检索策略评估了 SCS 对认知功能（即记忆力和注意力）的影响，但没有一篇论文符合本研究的纳入标准。脊髓刺激有效地解决了许多与 FBSS 相关的身体功能和睡眠问题；然而，需要进一步进行高质量的客观研究来支持这一点。
