Spinal Cord Stimulation: A Reasonable Alternative Treatment in Patients With Symptomatic Adult Scoliosis for Whom Surgical Therapy Is Not Suitable? A Pilot Study.
Adult degenerative scoliosis
SCS
depression
quality of life
sleep quality
Journal
Neuromodulation : journal of the International Neuromodulation Society
ISSN: 1525-1403
Titre abrégé: Neuromodulation
Pays: United States
ID NLM: 9804159
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
revised:
08
12
2020
received:
09
10
2020
accepted:
08
12
2020
pubmed:
10
2
2021
medline:
18
12
2021
entrez:
9
2
2021
Statut:
ppublish
Résumé
In adult scoliosis, dorsal instrumentation and fusion can provide significant improvement of pain and disability scores (Owestry Index); however, complication rates of up to 39% have been reported. As such, recent attempts have been made at expanding the surgical spectrum to include less invasive techniques in patients such as neuromodulation, specifically spinal cord stimulation (SCS). We therefore aimed to evaluate its use in a larger cohort of adult scoliosis patients in the form of a pilot study. We analyzed prospectively collected data from 18 adult scoliosis patients receiving SCS treatment in our institution between February 2019 and May 2020. Clinical follow-up was performed at 3, 6, and 12 months following implantation of an epidural SCS System. Patients reported numeric rating scale (NRS) values for the categories of lower back pain (LBP) and regional pain (RP) both at rest and in motion. Further, SF-36, ADS-K, PSQI, and ODI forms were completed. The study was approved by the institutional Ethics Committee (EA2/093/13). Initial preoperative NRS of LBP at rest was significantly reduced following SCS at three (45% reduction, p = 0.005) and six (43% reduction, p = 0.009) months follow-up. LBP in motion was also reduced at three (27% reduction, p = 0.002) and six (33% reduction vs. preoperative, p = 0.005) months. RP at rest was reduced at three (38% reduction, p = 0.003) and six (37% reduction, p = 0.007) and in movement at three (29% reduction, 0.006) and six (32% reduction, p = 0.011). Loss of thoracic kyphosis and increased pelvic incidence were associated with worse NRS response to SCS stimulation at six months follow-up. In overweight, older adults for whom the risks of corrective surgery must be carefully considered, neuromodulation can significantly reduce LBP as well as regional pain in the first six months following implantation. These findings may provide a reasonable alternative in patients not willing or eligible to undergo extensive corrective surgery.
Identifiants
pubmed: 33560562
doi: 10.1111/ner.13351
pii: S1094-7159(21)06917-8
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1370-1376Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2021 The Authors. Neuromodulation: Technology at the Neural Interface published by Wiley Periodicals LLC on behalf of International Neuromodulation Society.
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