Spinal cord stimulation and return to work of patients with failed back surgery syndrome

Author:

Dauriac‐Le Masson Valérie1ORCID,Gatt Marie‐Thérèse2,Chekroun Corinne2,Turak Baris3,Djian Marie Christine4

Affiliation:

1. Department of Medical Information GHU Paris Psychiatrie & Neurosciences Paris France

2. Department of Anesthesia GHU Paris Psychiatrie & Neurosciences Paris France

3. Department of Neurosurgery GHU Paris Psychiatrie & Neurosciences Paris France

4. Department of Anesthesia Hospital Foch Suresnes France

Abstract

AbstractObjectivesChronic pain has a substantial negative impact on work‐related outcomes, which underlines the importance of interventions to reduce the burden. Spinal cord stimulation (SCS) efficiently relieves pain in specific chronic pain syndromes and is recommended for treating failed back surgery syndrome (FBSS) or post‐surgical chronic back pain that is refractory to other treatments. To examine the impact of SCS in patients with FBSS on the return to work (RTW), we determined the RTW rate and the factors positively associated with the RTW.Materials and MethodsAmong 106 patients with FBSS who benefitted from SCS at a single institution in France between September 1999 and March 2010, we retrospectively included 59 who had stopped work at the time of SCS because of disability or sick leave and evaluated the RTW (rate and predictors, estimating odds ratios [ORs] and 95% confidence intervals [CIs]).ResultsThe mean (SD) post‐surgery follow‐up for the 59 patients (34 men; mean [SD] age 46.9 [7.4] years) was 7.5 (3.6) years (range 5–15). The RTW rate was 30.5%, with a median [IQR] recovery time of 5.5 months [3–8.5]. RTW was improved with functional improvement evolution (OR 1.1, 95% CI [1.01–1.1], p = 0.02) and was reduced with unemployment > 3 years (OR 0.1, 95% CI [0.01–0.7], p = 0.02).ConclusionsOur protocol for SCS for patients with FBSS, including a strict selection of patients and a multidisciplinary approach, led to good results, especially for the RTW. RTW should be a therapeutic goal, directly affecting indirect costs related to FBSS.

Publisher

Wiley

Subject

Anesthesiology and Pain Medicine

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