Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands.
Neuromodulation. 2021 Jan;24(1):112-125. doi: 10.1111/ner.13277. Epub 2020 Sep 23.
When neither pharmacological therapies nor alternative interventions provide sufficient pain relief, spinal cord stimulation (SCS) can be used to treat Failed Back Surgery Syndrome (FBSS). Although it seems reasonable that quality of life (QoL)- and psychosocial-related factors contribute to the outcome of SCS since pain is a multidimensional experience, few qualitative studies have explored the expectations of SCS and experiences on SCS to treat FBSS from the patient perspective.
The aim of this study was to qualitatively and quantitatively map the FBSS patients' experiences with SCS and the effects of SCS on low back pain caused by FBSS.
A qualitative study with in-depth semi-structured interviews, assisted by the Brief Pain Inventory (BPI)-questionnaire.
Seven themes regarding patients' experiences, subdivided into 15 categories, were identified, including an understudied theme within this field of research, Spiritual Well-Being. "Acceptance" and "coping" emerged as pre-eminent motifs throughout these themes. Moreover, the realization of patients' expectations were variable throughout the presented themes. According to the BPI Questionnaire, four out of 13 patients (31%) had significant pain relief (≥50%). Seven out of 13 (54%) reported a ≥50% increase regarding enjoyment of life.
Multiple QoL- and psychosocial-related themes are related to SCS-outcomes. In order to improve SCS-outcomes for both short- and long-term, these themes should be implemented as a multidimensional approach, both prior to implantation as during follow-up.
当药物治疗和替代干预都不能提供足够的疼痛缓解时，可以使用脊髓刺激（SCS）来治疗失败的腰椎手术综合征（FBSS）。尽管从疼痛是一种多维体验的角度来看，生活质量（QoL）和心理社会相关因素可能会影响 SCS 的结果，这似乎是合理的，但很少有定性研究从患者角度探讨 SCS 的期望以及 SCS 治疗 FBSS 的经验。
本研究的目的是从定性和定量两方面描述 FBSS 患者对 SCS 的体验以及 SCS 对 FBSS 引起的腰痛的影响。
采用定性研究方法，对 13 名患者进行深入的半结构化访谈，并辅以简短疼痛量表（BPI）问卷。
确定了七个与患者体验相关的主题，细分为 15 个类别，其中包括该研究领域中一个被低估的主题，即精神健康。“接受”和“应对”是这些主题中突出的主题。此外，患者期望的实现在整个主题中各不相同。根据 BPI 问卷，13 名患者中有 4 名（31%）疼痛明显缓解（≥50%）。13 名患者中有 7 名（54%）报告生活享受度提高≥50%。
多个与 QoL 和心理社会相关的主题与 SCS 结果相关。为了提高 SCS 的短期和长期效果，这些主题应该作为一个多维的方法来实施，包括在植入前和随访期间。
