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SCS als therapeutische Option beim Postnukleotomiesyndrom

SCS as a treatment option for failed back surgery syndrome

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Zusammenfassung

Etwa 10–40 % der Patienten sind nach Operationen an der Wirbelsäule nicht beschwerdefrei. Die Ursachen können vielfältig sein. Wenn sich keine eindeutige Ursache, wie z. B. ein neuer Bandscheibenvorfall, darstellen lässt, spricht man gerne von einem Postnukleotomiesyndrom. Dieser Begriff subsumiert eine Vielzahl von möglichen Schmerzursachen. Entsprechend vielfältig sind auch die Therapieansätze. Neben medikamentösen, verhaltenstherapeutischen und physiotherapeutischen Maßnahmen, bieten sich bereits seit langem auch nichtinvasive und invasive Neuromodulationstechniken an. Die bekannteste Methode ist die epidurale Rückenmarkstimulation oder SCS (spinal cord stimulation). Im folgenden Artikel sollen evidenzbasierte Studien zum Erfolg der konventionellen tonischen Rückenmarkstimulation beim Postnukleotomiesyndrom und neuere Entwicklungen, insbesondere zur Behandlung der therapierefraktären Rückenschmerzen, vorgestellt werden.

Abstract

Unfortunately, 10–40 % of patients still experience pain after spinal surgery. There are many reasons for the patients’ complaints. If no identifiable cause, such as a recurrent disc herniation, is visible, this is referred to as failed back surgery syndrome. However, this definition includes a variety of possible underlying causes of the pain, which result in just as many different therapeutic approaches. In addition to pharmacological, behavioral and physical therapy, also neuromodulation techniques can be offered; the best known method is spinal cord stimulation (SCS). The following article describes evidence-based studies with regard to the beneficial treatment of failed back surgery syndrome with conventional tonic SCS and new developments in spinal cord stimulation addressing the treatment of chronic refractory back pain.

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Authors and Affiliations

  1. Universitätsklinikum Schleswig-Holstein, Klinik für Neurochirurgie Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Deutschland

    V. Tronnier

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  1. V. Tronnier
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Correspondence to V. Tronnier.

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Interessenkonflikt

V. Tronnier weist auf folgende Beziehungen hin: Vortragshonorare von EISAI, St. Jude und Medtronic, Research Grants von St. Jude und Medtronic, Advisory Board EISAI.

Dieser Beitrag beinhaltet keine vom Autor durchgeführten Studien an Menschen oder Tieren.

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Tronnier, V. SCS als therapeutische Option beim Postnukleotomiesyndrom. Orthopäde 45, 738–743 (2016). https://doi.org/10.1007/s00132-016-3310-5

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