Practice Parameters for the Use of Spinal Cord Stimulation in the Treatment of Chronic Neuropathic Pain

Function

Although improved neurologic or physical functioning, e.g., lower extremity strength and coordination, sensation, and bladder/bowel function, is not an expected direct benefit of SCS treatment, such an improvement has been reported and might be an indirect benefit of pain control or discontinuation of other treatment (viz., opioids).  The primary method of gaining information on changes in neurologic function is patient self-report; however, validated scales exist for some conditions (e.g., spinal cord injury).

Strength of recommendation Evidence source(s)/rationale
N/A -- Information only N/A -- see Bibliography for relevant literature

Harding VR, Williams AC, Richardson PH, Nicholas MK, Jackson JL, Richardson IH, Pither CE. The development of a battery of measures for assessing physical functioning of chronic pain patients. Pain 58:367-375, 1994.
Abstract

Deyo RA. Measuring the functional status of patients with low back pain. Arch Phys Med Rehabil 69:1044-1053, 1988.
Abstract

Improved neurologic/physical function in long-term follow-up studies

Rainov NG, Heidecke V, Burkert W. Short test-period spinal cord stimulation for failed back surgery syndrome. Minim Invasive Neurosurg 39(2):41-44, 1996.
Abstract | Wikistim Entry

Ohnmeiss DD, Rashbaum RF, Bogdanffy GM. Prospective outcome evaluation of spinal cord stimulation in patients with intractable leg pain. Spine 21(11):1344-1350, 1996.
Abstract | Wikistim Entry

North RB, Kidd DH, Olin J, Sieracki JM, Farrokhi F, Petrucci L, Cutchis PN. Spinal cord stimulation for axial low back pain: a prospective, controlled trial comparing dual with single percutaneous electrodes. Spine 30(12):1412-1418, 2005.
Abstract | Wikistim Entry

Kumar K, Hunter G, Demeria D. Spinal cord stimulation in treatment of chronic benign pain: challenges in treatment planning and present status, a 22-year experience. Neurosurgery 58(3):481-494, 2006.
Abstract | Wikistim Entry

Kiwerski J. Stimulation of the spinal cord in the treatment of traumatic injuries of cervical spine. Appl Neurophysiol 49(3):166-171, 1986.
Abstract | Wikistim Entry

Huang H, He J, Herman R, Carhart MR. Modulation effects of epidural spinal cord stimulation on muscle activities during walking. IEEE Trans Neural Syst Rehabil 14(1):14-23, 2006.
Abstract | Wikistim Entry

Hirata Y, Murakami M, Ushio Y. Successful treatment by spinal cord stimulation for gait disturbance in a patient with diffuse axonal injury. Acta Neurochir Suppl 87:49-52, 2003.
Abstract | Wikistim Entry

Budd K. Spinal cord stimulation: cost-benefit study. Neuromodulation 5(2):75-78, 2002.
Abstract | Wikistim Entry

Barolat G, Singh-Sahni K, Staas WE Jr, Shatin D, Ketcik B, Allen K. Epidural spinal cord stimulation in the management of spasms in spinal cord injury: a prospective study. Stereotact Funct Neurosurg 64(3):153-164, 1995.
Abstract | Wikistim Entry

Improved neurologic/physical function in short-term follow-up studies

Spincemaille GH, Beersen N, Dekkers MA, Theuvenet PJ. Neuropathic limb pain and spinal cord stimulation: results of the Dutch prospective study. Neuromodulation 7(3):184-192, 2004.
Abstract | Wikistim Entry

Oakley JC, Weiner RL. Spinal cord stimulation for complex regional pain syndrome: a prospective study of 19 patients at two centers. Neuromodulation 2(1):47-50, 1999.
Abstract | Wikistim Entry

Harke H, Gretenkort P, Ladleif HU, Rahman S. Spinal cord stimulation in sympathetically maintained complex regional pain syndrome type I with severe disability. A prospective clinical study. Eur J Pain 9(4):363-373, 2005.
Abstract | Wikistim Entry

Burchiel KJ, Anderson VC, Brown FD, Fessler RG, Friedman WA, Pelofsky S, Weiner RL, Oakley J, Shatin D. Prospective, multicenter study of spinal cord stimulation for relief of chronic back and extremity pain. Spine 21(23):2786-2794, 1996.
Abstract | Wikistim Entry

Burchiel KJ, Anderson VC, Wilson BJ, Denison DB, Olson KA, Shatin D. Prognostic factors of spinal cord stimulation for chronic back and leg pain. Neurosurgery 36(6):1101-1110, 1995.
Abstract | Wikistim Entry

Allegri M, Arachi G, Barbieri M, Paulin L, Bettaglio R, Bonetti G, Demartini L, Violini A, Braschi A, Bonezzi C. Prospective study of the success and efficacy of spinal cord stimulation. Minerva Anestesiol 70(3):117-124, 2004.
Abstract | Wikistim Entry

Improved neurologic/physical function in case reports

Loubser PG. Adverse effects of epidural spinal cord stimulation on bladder function in a patient with chronic spinal cord injury pain. J Pain Symptom Manage 13(5):251-252, 1997.
Abstract | Wikistim Entry

Carhart MR, He J, Herman R, D'Luzansky S, Willis WT. Epidural spinal-cord stimulation facilitates recovery of functional walking following incomplete spinal-cord injury. IEEE Trans Neural Syst Rehabil Eng 12(1):32-34, 2004.
Abstract | Wikistim Entry

Buonocore M, Demartini L, Bonezzi C. Lumbar spinal cord stimulation can improve muscle strength and gait independently of the analgesic effect: a case report. Neuromodulation 9(4):309-313, 2006.
Abstract | Wikistim Entry