Multicolumn Spinal Cord Stimulation for Chronic Back and Leg Pain in Patients with Failed Back Surgery Syndrome: A Systematic Review and Meta-Analysis

Abstract

Introduction

Failed Back Surgery Syndrome (FBSS) presents a formidable challenge, marked by the persistence of chronic lower back pain and leg pain despite undergoing surgical interventions. Multicolumn spinal cord stimulation (m-SCS) has recently emerged as a promising therapeutic strategy for addressing the pain associated with FBSS. This meta-analysis aims to study the efficacy of m-SCS in mitigating chronic back and leg pain among patients with FBSS.

Methods

A comprehensive search of electronic databases (PubMed, Web of Science, Scopus, Cochrane Library) was conducted to identify relevant studies published up to October 25th, 2023. Inclusion criteria encompassed randomized controlled trials and cohort studies evaluating the outcomes of m-SCS in patients with FBSS. The primary outcome measured was the Visual Analog Scale (VAS) score for low back and leg pain at baseline, six months, and 12 months.

Results

A total of eight studies, including 271 patients, were analyzed. At six months, there was a statistically significant reduction in the VAS scores for low back pain (MD, 4.76; 95% CI, 3.78 to 5.74) and leg pain (MD, 4.41; 95% CI, 2.93 to 5.90) compared to baseline. Similarly, at 12 months, there was a statistically significant reduction in the VAS scores for low back pain (MD, 4.77; 95% CI, 4.34 to 5.20) and leg pain (MD, 2.78; 95% CI, 0.72 to 4.85) compared to baseline.

Conclusion

m-SCS effectively manages chronic back and leg pain in FBSS patients, providing sustained pain relief. Studies with more extended follow-up periods and qualitative analysis for the functional outcomes and overall improvement for the patients with FBSS are recommended.