EPV022 - HIGH-DOSE SPINAL CORD STIMULATION REDUCES LONG-TERM PAIN MEDICATION USE IN PATIENTS WITH FAILED BACK SURGERY SYNDROME: A REGISTRY-BASED COHORT STUDY. (ID 478)
- Maarten Moens, Belgium
- Lisa Goudman, Belgium
- Ann De Smedt, Belgium
- Patrice Forget, Belgium
- Sam Eldabe, United Kingdom
- Discover Discover, Belgium
- Maarten Moens, Belgium
Abstract
Introduction
High-dose Spinal Cord Stimulation (HD-SCS) revealed positive results for obtaining pain relief in patients with Failed Back Surgery Syndrome (FBSS). Several studies pointed out the beneficial effects of SCS to reduce pain medication use and more specifically opioid consumptions, compared to best medical treatment. It is, however, less clear whether HD-SCS is also able to reduce pain medication use in this population. Therefore, the aim of this registry-based cohort study is to explore the impact of HD-SCS on pain medication use in patients with FBSS.
Methods/Materials
Individual patient data from the Discover registry was used in which the effectiveness of HD-SCS was explored in neurostimulation-naïve FBSS patients as well as in rescue patients. Medication use was measured with the Medication Quantification Scale III (MQS) in 259 patients at baseline (i.e. before HD-SCS) and at 1, 3 and 12 months of HD-SCS. Additionally, defined daily doses (DDD) and morphine milligram equivalents (MME) were calculated as well.
Results
In neurostimulation-naïve patients, a statistically significant decrease in MQS (χ²=62.92,p<0.001), DDD (χ²=11.47,p=0.009) and MME (χ²=21.55,p<0.001) was found over time. In rescue patients, no statistically significant improvement in MQS, DDD or MME scores were found. In both patient groups, a statistically significant reduction in the proportion of patients on high-risk MME doses ≥90 was found over time. At the intra-individual level, positive correlations were found between MSQ scores and pain intensity scores for back pain and leg pain in neurostimulation-naïve and rescue patients.
Discussion
Real world data on HD-SCS in patients with FBSS revealed a statistically significant and sustained decrease in pain medication use, not only on opioids, but also on anti-neuropathic agents. Additionally, the current analysis demonstrated that HD-SCS is also beneficial for high risk patients by reducing the large amount of opioids.
Conclusions
In line with the results of other stimulation paradigms, HD-SCS is able to reduce pain medication use in patients with FBSS.
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