EPV021 - LONG-TERM QUALITY OF LIFE AND WORK STATUS AFTER HIGH DOSE SPINAL CORD STIMULATION IN PATIENTS WITH FAILED BACK SURGERY SYNDROME (ID 471)
- Maarten Moens, Belgium
- Lisa Goudman, Belgium
- Ann De Smedt, Belgium
- Koen Putman, Belgium
- Discover Discover, Belgium
- Maarten Moens, Belgium
Abstract
Introduction
During the last years, the use of High Dose SCS (HD-SCS) has drastically increased as treatment strategy for patients with Failed Back Surgery Syndrome (FBSS). However, a thorough evaluation of health-related quality of life (HRQoL) and work status of this type of neuromodulation has not yet been performed. Moreover, it is not yet explored whether patients who are treated with HD-SCS can regain the same levels of HRQoL as the general population. Therefore, the aims of this study are 1) to compare HRQoL of patients who receive HD-SCS to age-and sex-adjusted population norms 2) to evaluate work status in patients who are receiving HD-SCS.
Methods/Materials
HRQoL was measured with the EQ5D-3L in 185 FBSS patients at baseline (i.e. before SCS) and at 1, 3 and 12 months of HD-SCS. Difference scores in utility values between patients and age-and sex adjusted population norms were calculated. One-sample Wilcoxon tests were used to assess the EQ5D-3L difference scores. Mixed models were used to evaluate the evolution over time in EQ5D-3L utility scores and EQ5D VAS scores in patients and matched controls. Quality adjusted life years (QALY) were calculated as well. Work status was evaluated at 12 months of SCS.
Results
An overall significant increase in EQ5D-3L utility score and EQ5D VAS score was found over time. Wilcoxon tests indicated that the difference utility scores (between patients and normal population) were significantly different from zero at all time points. The median incremental QALY after 12 months of HD-SCS was 0.228 (Q1-Q3: 0.005 – 0.487) in comparison to continued conservative treatment. At 12 months, 13.75% patients resumed work.
Discussion
HD-SCS is able to significantly increase HRQoL at 12 months in patients with FBSS. Despite the increase, reaching HRQoL up to the level of matched controls was not achieved. Only a limited number of patients is able to return to work, for which specialized programs to enhance return to work may possibly find their way in the field of SCS.
Conclusions
From an HRQOL point of view, HD-SCS seems to be an effective treatment option for patients with FBSS.
/thumbnails/0.png)
/thumbnails/0.jpg)
/thumbnails/0.png)
