Neurostimulation therapy for the treatment of chronic back pain

Abstract Backround Back pain remains one of the leading causes of years lived in disability globally, and the prevalence continues to increase worldwide. Neurostimulation involves the application of an electric current to the peripheral nerves or to the dorsal columns of the spinal cord; this can attenuate pain signals relayed by ascending pain pathways to the brain. The mechanisms of action are complex—at the spinal and supraspinal levels. Aims To evaluate the long-terms efficacy and safety of neurostimulation for the treatment of chronic back/leg pain. Methods This is a retrospective, one center study analysing patients’medical records and a self-reported questionnaire—the Oswestry Disability Index (ODI). We compared the intensity of pain, the consumption of opioids and co-analgesics and the quality of life before SCS and 6 and 12 months after the treatment in 61 adult patients. The ability to work, patient satisfaction, mode of implantation and the rate of complications were also monitored. Results We observed a significant reduction in pain intensity (p < 0.001) along with a reduction in opioid consumption both 6 and 12 months after the implantation (p < 0.001). The quality of life, according to the Oswestry Disability Index, also improved. The rate of serious complications was low. Conclusion Despite the fact that some authors consider neuromodulation to be a placebo treatment, in this study, over 12 months, neurostimulation provided durable pain relief and significant improvement in the ODI. The findings support neurostimulation as an effective and safe therapy in the management of chronic back and leg pain in properly selected patients.