Date of Award

8-10-2021

Document Type

Open Access Thesis

Degree Name

MS in Physician Assistant Studies (PA)

Department

Physician Assistant Studies

First Advisor

Advisor: Vanessa Bester, EdD, PA-C

Abstract

Background: Spinal cord stimulation (SCS) is commonly used to treat chronic neuropathic pain. A common indication for the SCS is failed back surgery syndrome (FBSS). There are many interventional approaches to treating lumbar pain; however, the SCS may provide the greatest benefit in terms of health care utilization and overall pain relief to the patient.

Objective: The goal of this paper is to assess the effectiveness of SCS compared to conventional therapies such as physical therapy, oral medications, radiofrequency ablations (RFA), epidural steroid injections (ESI), and intrathecal pain pumps (IT pain pump) in patients with chronic lumbar pain due to FBSS.

Methods: A comprehensive literature review was conducted to determine the effectiveness of the SCS. Interventions to treat FBSS were identified from least invasive to most invasive. PubMed and Google Scholar were primarily used to search for relevant literature. The following terms were used for this review: “spinal cord stimulation,” “chronic low back pain,” “conservative treatments,” “costs and cost analysis,” and “failed back surgery syndrome.”

Discussion: Treatment for chronic lumbar pain begins with minimally invasive treatments such as physical therapy and medication management, and then may progress to more invasive treatments such as ESI, RFA, or IT pain pumps. When compared to these therapies, the SCS was associated with favorable outcomes and found to be more cost effective.

Conclusion: For the treatment of chronic lumbar pain, the majority of studies suggest SCS as potentially more cost effective and efficient than conventional therapies; however, a multidisciplinary approach may provide the greatest benefit. SCS therapy may yet play a role in mitigating the financial burden associated with chronic lumbar pain.

Identifier

SC 11.PAS.2021.Botros.D

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