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Younger age predicts greater effectiveness of spinal cord stimulation for chronic pain

  • Clinical Article - Functional
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Abstract

Background

Spinal cord stimulation (SCS) is an accepted surgical treatment for neuropathic pain in failed back syndrome or complex regional pain syndrome. However, even in the best selected surgical cases the predictors of adequate pain control are not well defined. The aim of this study was to identify predictors of outcome in patients who underwent SCS in our center.

Methods

We performed a retrospective analysis of our neurosurgical database for patients who underwent SCS over the last 8 years in an attempt to identify factors predictive of outcome.

Results

Forty-one patients underwent implantation of epidural electrodes, 34 patients had a successful stimulation trial and received permanent devices. Nine patients experienced a late failure at a median time of 7.8 months (range, 4.5–19 months) after implantation. Age was significantly associated with outcome. Younger patients had a significantly lower rate of treatment failure, and none of the patients above 65 years had a successful long-term outcome.

Conclusions

Our results suggest that younger age is associated with greater long-term effectiveness of spinal cord stimulation and therefore age may influence the success of SCS therapy with older patients having a greater tendency to failure. Earlier intervention may be beneficial in these chronic pain patients.

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Author notes

    Authors and Affiliations

    1. Department of Surgery, Division of Neurosurgery, University of Toronto, Toronto Western Hospital, Toronto, ON, Canada

      Ido Strauss, Vibhor Krishna & Mojgan Hodaie

    2. Faculty of Medicine, University of Toronto, Toronto, ON, Canada

      Karim Taha

    Authors
    1. Ido Strauss
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    2. Karim Taha
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    3. Vibhor Krishna
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    4. Mojgan Hodaie
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    Correspondence to Mojgan Hodaie.

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    Funding

    No funding was received for this research.

    Conflict of interest statement

    Dr. Hodaie has received an honorarium grant from Medtronic and research support from St. Jude. All the other authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers' bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

    Ethical approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

    Additional information

    Ido Strauss and Karim Taha contributed equally to this work.

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    Strauss, I., Taha, K., Krishna, V. et al. Younger age predicts greater effectiveness of spinal cord stimulation for chronic pain. Acta Neurochir 158, 999–1003 (2016). https://doi.org/10.1007/s00701-016-2753-0

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    • DOI: https://doi.org/10.1007/s00701-016-2753-0

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