Eckermann Jan M, Pilitsis Julie G, Vannaboutathong Christopher, Wagner Belinda J, Province-Azalde Rose, Bendel Markus A
Eckermann Pain & Spine, Newport Beach, California, USA.
Albany Medical Center, Albany, New York, USA.
Neuromodulation. 2021 Aug 18. doi: 10.1111/ner.13519.
Low back pain is the leading cause of disability worldwide and one of the most common reasons for seeking healthcare. Despite numerous care strategies, patients with low back pain continue to exhibit poor outcomes. Spinal cord stimulation (SCS) is an evidence-based therapeutic modality for patients with failed back surgery syndrome. For patients without a surgical lesion or history, minimally invasive interventions that provide long-term reduction of chronic back pain are needed. Therefore, we conducted a systematic review of the evidence on SCS therapy in patients with chronic back pain who have not undergone spinal surgery.
A systematic literature search was performed to identify studies reporting outcomes for SCS in chronic back pain patients (with or without secondary radicular leg pain) without prior surgery using date limits from database inception to February 2021. Study results were analyzed and described qualitatively.
A total of ten primary studies (16 publications) were included. The included studies consistently demonstrated favorable outcomes in terms of pain reduction and functional improvement following SCS therapy. Improvements also occurred in quality of life scores; however, not all studies reported statistically significant findings. Additionally, the studies reported that SCS resulted in high patient satisfaction, reductions in opioid use, and an acceptable safety profile, although these data were more limited.
Findings suggest that SCS is a promising, safe, minimally invasive, and reversible alternative option for managing chronic back pain in patients who have not undergone spinal surgery.
腰背痛是全球致残的主要原因，也是寻求医疗保健最常见的原因之一。尽管有众多的治疗策略，但腰背痛患者的治疗效果仍然不佳。脊髓刺激（SCS）是治疗腰椎手术失败综合征患者的一种循证治疗方式。对于没有手术损伤或手术史的患者，需要能够长期减轻慢性背痛的微创干预措施。因此，我们对未接受脊柱手术的慢性背痛患者的SCS治疗证据进行了系统评价。
进行系统的文献检索，以确定报告未接受过手术的慢性背痛患者（有或无继发性神经根性腿痛）SCS治疗结果的研究，检索日期范围从数据库建立到2021年2月。对研究结果进行定性分析和描述。
共纳入10项主要研究（16篇出版物）。纳入的研究一致表明，SCS治疗后在疼痛减轻和功能改善方面有良好的效果。生活质量评分也有所改善；然而，并非所有研究都报告了具有统计学意义的结果。此外，研究报告称，SCS导致患者满意度高、阿片类药物使用减少，且安全性良好，尽管这些数据较为有限。
研究结果表明，对于未接受脊柱手术的慢性背痛患者，SCS是一种有前景、安全、微创且可逆的替代治疗选择。
