Attrition with spinal cord stimulation

S. A. Mann, Elizabeth Sparkes, R. V. Duarte, J. H. Raphael

    Research output: Contribution to journalArticle

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    Abstract

    The aim of this prospective study was to investigate whether spinal cord stimulation (SCS) significantly reduces pain intensity for up to 18-month follow-up in patients with chronic neuropathic pain. Forty-eight patients were recruited. Patients rated their pain using a Visual analog scale (VAS) and pain-related disability using the Oswestry Disability Index (ODI) at baseline (1 week prior to SCS surgery) and at 6-, 12-, and 18-month follow-up. Pain intensity significantly decreased from baseline to all 3 time points [F (3,135) = 16.264, p <0.001]. The greatest difference in the reduction of pain intensity was observed between baseline (M = 7.20, SD = 1.34) and 6-month follow-up (M = 4.60, SD = 2.20), [t(47) = 6.741, p <0.001]. However, when looking at differences between the 6-month follow-up and subsequent assessments, statistically significant increases in pain intensity from the 6-month to the 12-month follow-up [t(47) = −2.788, p = 0.008], and from the 6-month to the 18-month follow-up [t(47) = −3.339, p = 0.002] could be observed. Statistically significant changes were also observed for clinical changes in pain scores [F (2,94) = 4.972, p = 0.009. There was a significant decrease in the percentage of clinical change obtained from the 6-month (M = 33.19, SD = 35.63) to the 12-month follow-up (M = 23.76, SD = 33.62), [t(47) = 2.347, p = 0.025], and from the 6-month to the 18-month follow-up (M = 18.34, SD = 33.51), [t(47) = 3.072, p = 0.004]. A number of patients also reported higher levels of pain intensity at the 12-and 18-month follow-up than at baseline. Pain-related disability scores significantly decreased from baseline (M = 55.04, SD = 16.43) to the 6-month follow up (M = 46.98, SD = 19.05), [t(47) = 3.464, p = 0.001] and from baseline to the 12-month follow up (M = 48.49, SD = 20.94), [t(47) = 2.918, p = 0.005], but not during the 18-month follow up (M = 51.75, SD = 20.92), [t(47) = 1.330, p = .190]. There was a significant increase in pain-related disability between the 6- and the 18-month follow up [t(47) = −2.188. p = 0.034]. These findings suggest that the beneficial effect of SCS on pain intensity may diminish over time, and that the 6-month follow-up scores may reflect a placebo effect. Publisher statement: This is an Accepted Manuscript of an article published by Taylor & Francis in the British Journal of Neurosurgery on 18th June 2015, available online: http://www.tandfonline.com/doi/full/10.3109/02688697.2015.1054352 .
    Original languageEnglish
    Pages (from-to)823-828
    JournalBritish Journal of Neurosurgery
    Volume29
    Issue number6
    DOIs
    Publication statusPublished - 18 Jun 2015

    Fingerprint

    Spinal Cord Stimulation
    Pain
    Placebo Effect
    Manuscripts
    Neurosurgery
    Neuralgia
    Pain Measurement
    Chronic Pain
    Prospective Studies

    Bibliographical note

    Due to publisher policy, the full text will not be available on the repository until the 18th of June 2016.
    This is an Accepted Manuscript of an article published by Taylor & Francis in the British Journal of Neurosurgery on 18th June 2015, available online: http://www.tandfonline.com/doi/full/10.3109/02688697.2015.1054352 .

    Keywords

    • attrition
    • chronic pain
    • clinical efficacy
    • neuropathic pain
    • spinal cord stimulation

    Cite this

    Mann, S. A., Sparkes, E., Duarte, R. V., & Raphael, J. H. (2015). Attrition with spinal cord stimulation. British Journal of Neurosurgery, 29(6), 823-828. https://doi.org/10.3109/02688697.2015.1054352

    Attrition with spinal cord stimulation. / Mann, S. A.; Sparkes, Elizabeth; Duarte, R. V.; Raphael, J. H.

    In: British Journal of Neurosurgery, Vol. 29, No. 6, 18.06.2015, p. 823-828.

    Research output: Contribution to journalArticle

    Mann, SA, Sparkes, E, Duarte, RV & Raphael, JH 2015, 'Attrition with spinal cord stimulation' British Journal of Neurosurgery, vol. 29, no. 6, pp. 823-828. https://doi.org/10.3109/02688697.2015.1054352
    Mann, S. A. ; Sparkes, Elizabeth ; Duarte, R. V. ; Raphael, J. H. / Attrition with spinal cord stimulation. In: British Journal of Neurosurgery. 2015 ; Vol. 29, No. 6. pp. 823-828.
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    abstract = "The aim of this prospective study was to investigate whether spinal cord stimulation (SCS) significantly reduces pain intensity for up to 18-month follow-up in patients with chronic neuropathic pain. Forty-eight patients were recruited. Patients rated their pain using a Visual analog scale (VAS) and pain-related disability using the Oswestry Disability Index (ODI) at baseline (1 week prior to SCS surgery) and at 6-, 12-, and 18-month follow-up. Pain intensity significantly decreased from baseline to all 3 time points [F (3,135) = 16.264, p <0.001]. The greatest difference in the reduction of pain intensity was observed between baseline (M = 7.20, SD = 1.34) and 6-month follow-up (M = 4.60, SD = 2.20), [t(47) = 6.741, p <0.001]. However, when looking at differences between the 6-month follow-up and subsequent assessments, statistically significant increases in pain intensity from the 6-month to the 12-month follow-up [t(47) = −2.788, p = 0.008], and from the 6-month to the 18-month follow-up [t(47) = −3.339, p = 0.002] could be observed. Statistically significant changes were also observed for clinical changes in pain scores [F (2,94) = 4.972, p = 0.009. There was a significant decrease in the percentage of clinical change obtained from the 6-month (M = 33.19, SD = 35.63) to the 12-month follow-up (M = 23.76, SD = 33.62), [t(47) = 2.347, p = 0.025], and from the 6-month to the 18-month follow-up (M = 18.34, SD = 33.51), [t(47) = 3.072, p = 0.004]. A number of patients also reported higher levels of pain intensity at the 12-and 18-month follow-up than at baseline. Pain-related disability scores significantly decreased from baseline (M = 55.04, SD = 16.43) to the 6-month follow up (M = 46.98, SD = 19.05), [t(47) = 3.464, p = 0.001] and from baseline to the 12-month follow up (M = 48.49, SD = 20.94), [t(47) = 2.918, p = 0.005], but not during the 18-month follow up (M = 51.75, SD = 20.92), [t(47) = 1.330, p = .190]. There was a significant increase in pain-related disability between the 6- and the 18-month follow up [t(47) = −2.188. p = 0.034]. These findings suggest that the beneficial effect of SCS on pain intensity may diminish over time, and that the 6-month follow-up scores may reflect a placebo effect. Publisher statement: This is an Accepted Manuscript of an article published by Taylor & Francis in the British Journal of Neurosurgery on 18th June 2015, available online: http://www.tandfonline.com/doi/full/10.3109/02688697.2015.1054352 .",
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    T1 - Attrition with spinal cord stimulation

    AU - Mann, S. A.

    AU - Sparkes, Elizabeth

    AU - Duarte, R. V.

    AU - Raphael, J. H.

    N1 - Due to publisher policy, the full text will not be available on the repository until the 18th of June 2016. This is an Accepted Manuscript of an article published by Taylor & Francis in the British Journal of Neurosurgery on 18th June 2015, available online: http://www.tandfonline.com/doi/full/10.3109/02688697.2015.1054352 .

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    N2 - The aim of this prospective study was to investigate whether spinal cord stimulation (SCS) significantly reduces pain intensity for up to 18-month follow-up in patients with chronic neuropathic pain. Forty-eight patients were recruited. Patients rated their pain using a Visual analog scale (VAS) and pain-related disability using the Oswestry Disability Index (ODI) at baseline (1 week prior to SCS surgery) and at 6-, 12-, and 18-month follow-up. Pain intensity significantly decreased from baseline to all 3 time points [F (3,135) = 16.264, p <0.001]. The greatest difference in the reduction of pain intensity was observed between baseline (M = 7.20, SD = 1.34) and 6-month follow-up (M = 4.60, SD = 2.20), [t(47) = 6.741, p <0.001]. However, when looking at differences between the 6-month follow-up and subsequent assessments, statistically significant increases in pain intensity from the 6-month to the 12-month follow-up [t(47) = −2.788, p = 0.008], and from the 6-month to the 18-month follow-up [t(47) = −3.339, p = 0.002] could be observed. Statistically significant changes were also observed for clinical changes in pain scores [F (2,94) = 4.972, p = 0.009. There was a significant decrease in the percentage of clinical change obtained from the 6-month (M = 33.19, SD = 35.63) to the 12-month follow-up (M = 23.76, SD = 33.62), [t(47) = 2.347, p = 0.025], and from the 6-month to the 18-month follow-up (M = 18.34, SD = 33.51), [t(47) = 3.072, p = 0.004]. A number of patients also reported higher levels of pain intensity at the 12-and 18-month follow-up than at baseline. Pain-related disability scores significantly decreased from baseline (M = 55.04, SD = 16.43) to the 6-month follow up (M = 46.98, SD = 19.05), [t(47) = 3.464, p = 0.001] and from baseline to the 12-month follow up (M = 48.49, SD = 20.94), [t(47) = 2.918, p = 0.005], but not during the 18-month follow up (M = 51.75, SD = 20.92), [t(47) = 1.330, p = .190]. There was a significant increase in pain-related disability between the 6- and the 18-month follow up [t(47) = −2.188. p = 0.034]. These findings suggest that the beneficial effect of SCS on pain intensity may diminish over time, and that the 6-month follow-up scores may reflect a placebo effect. Publisher statement: This is an Accepted Manuscript of an article published by Taylor & Francis in the British Journal of Neurosurgery on 18th June 2015, available online: http://www.tandfonline.com/doi/full/10.3109/02688697.2015.1054352 .

    AB - The aim of this prospective study was to investigate whether spinal cord stimulation (SCS) significantly reduces pain intensity for up to 18-month follow-up in patients with chronic neuropathic pain. Forty-eight patients were recruited. Patients rated their pain using a Visual analog scale (VAS) and pain-related disability using the Oswestry Disability Index (ODI) at baseline (1 week prior to SCS surgery) and at 6-, 12-, and 18-month follow-up. Pain intensity significantly decreased from baseline to all 3 time points [F (3,135) = 16.264, p <0.001]. The greatest difference in the reduction of pain intensity was observed between baseline (M = 7.20, SD = 1.34) and 6-month follow-up (M = 4.60, SD = 2.20), [t(47) = 6.741, p <0.001]. However, when looking at differences between the 6-month follow-up and subsequent assessments, statistically significant increases in pain intensity from the 6-month to the 12-month follow-up [t(47) = −2.788, p = 0.008], and from the 6-month to the 18-month follow-up [t(47) = −3.339, p = 0.002] could be observed. Statistically significant changes were also observed for clinical changes in pain scores [F (2,94) = 4.972, p = 0.009. There was a significant decrease in the percentage of clinical change obtained from the 6-month (M = 33.19, SD = 35.63) to the 12-month follow-up (M = 23.76, SD = 33.62), [t(47) = 2.347, p = 0.025], and from the 6-month to the 18-month follow-up (M = 18.34, SD = 33.51), [t(47) = 3.072, p = 0.004]. A number of patients also reported higher levels of pain intensity at the 12-and 18-month follow-up than at baseline. Pain-related disability scores significantly decreased from baseline (M = 55.04, SD = 16.43) to the 6-month follow up (M = 46.98, SD = 19.05), [t(47) = 3.464, p = 0.001] and from baseline to the 12-month follow up (M = 48.49, SD = 20.94), [t(47) = 2.918, p = 0.005], but not during the 18-month follow up (M = 51.75, SD = 20.92), [t(47) = 1.330, p = .190]. There was a significant increase in pain-related disability between the 6- and the 18-month follow up [t(47) = −2.188. p = 0.034]. These findings suggest that the beneficial effect of SCS on pain intensity may diminish over time, and that the 6-month follow-up scores may reflect a placebo effect. Publisher statement: This is an Accepted Manuscript of an article published by Taylor & Francis in the British Journal of Neurosurgery on 18th June 2015, available online: http://www.tandfonline.com/doi/full/10.3109/02688697.2015.1054352 .

    KW - attrition

    KW - chronic pain

    KW - clinical efficacy

    KW - neuropathic pain

    KW - spinal cord stimulation

    U2 - 10.3109/02688697.2015.1054352

    DO - 10.3109/02688697.2015.1054352

    M3 - Article

    VL - 29

    SP - 823

    EP - 828

    JO - British Journal of Neurosurgery

    JF - British Journal of Neurosurgery

    SN - 0268-8697

    IS - 6

    ER -