PMID- 33338990
OWN - NLM
STAT- MEDLINE
DCOM- 20211111
LR  - 20230617
IS  - 1547-5646 (Electronic)
IS  - 1547-5646 (Linking)
VI  - 34
IP  - 3
DP  - 2020 Dec 18
TI  - Long-term quality of life and work status after high-dose spinal cord stimulation 
      in patients with failed back surgery syndrome: a secondary analysis of real-world 
      data.
PG  - 440-448
LID - 10.3171/2020.7.SPINE20764 [doi]
AB  - OBJECTIVE: In recent years, the use of high-dose spinal cord stimulation (HD-SCS) 
      as a treatment option for patients with failed back surgery syndrome (FBSS) has 
      drastically increased. However, to the authors' knowledge a thorough evaluation 
      of health-related quality of life (HRQOL) and work status in these patients has 
      not yet been performed. Moreover, it is unclear whether patients who are treated 
      with HD-SCS can regain the same levels of HRQOL as the general population. 
      Therefore, the aims of this study were to compare the HRQOL of patients who 
      receive HD-SCS to HRQOL values in an age- and sex-adjusted population without 
      FBSS and to evaluate work status in patients who are receiving HD-SCS. METHODS: 
      HRQOL, measured with the 3-level EQ-5D (EQ-5D-3L), and work status were evaluated 
      in 185 FBSS patients at baseline (i.e., before SCS) and at 1, 3, and 12 months of 
      treatment with HD-SCS. Difference scores in utility values between patients and 
      an age- and sex-adjusted normal population were calculated. One-sample Wilcoxon 
      tests were used to assess the EQ-5D-3L difference scores. Mixed models were used 
      to evaluate the evolution over time in EQ-5D-3L utility scores and EQ-5D visual 
      analog scale (VAS) scores in patients and matched controls. Quality-adjusted 
      life-years (QALYs) were calculated using the area under the curve method. 
      RESULTS: An overall significant increase in EQ-5D-3L utility scores and EQ-5D VAS 
      scores was found over time in the patient group. Wilcoxon tests indicated that 
      the difference scores in utility values between patients and the normal 
      population were significantly different from zero at all time points. The median 
      incremental QALY after 12 months of HD-SCS was 0.228 (Q1-Q3: 0.005-0.487) in 
      comparison to continued conservative treatment. At 12 months, 13.75% of patients 
      resumed work. CONCLUSIONS: HD-SCS may lead to significantly increased HRQOL at 12 
      months in patients with FBSS. Despite the increase, reaching the HRQOL level of 
      matched controls was not achieved. Only a limited number of patients were able to 
      return to work. This finding indicates that specialized programs to enhance 
      return to work may be beneficial for patients undergoing SCS.
FAU - Goudman, Lisa
AU  - Goudman L
AD  - 1Department of Neurosurgery, Universitair Ziekenhuis Brussel, Jette.
AD  - 2Center for Neurosciences (C4N), Vrije Universiteit Brussel, Jette.
AD  - 3STIMULUS Consortium (reSearch and TeachIng neuroModULation Uz bruSsel), 
      Universitair Ziekenhuis Brussel, Brussels.
AD  - 4Pain in Motion International Research Group, Jette.
FAU - De Smedt, Ann
AU  - De Smedt A
AD  - 2Center for Neurosciences (C4N), Vrije Universiteit Brussel, Jette.
AD  - 3STIMULUS Consortium (reSearch and TeachIng neuroModULation Uz bruSsel), 
      Universitair Ziekenhuis Brussel, Brussels.
AD  - 5Department of Physical Medicine and Rehabilitation, Universitair Ziekenhuis 
      Brussel, Jette.
FAU - Putman, Koen
AU  - Putman K
AD  - 6Department of Public Health (GEWE), Vrije Universiteit Brussel (VUB), Jette.
AD  - 7I-CHER, Interuniversity Center for Health Economics Research, Vrije Universiteit 
      Brussel (VUB), Jette; and.
FAU - Moens, Maarten
AU  - Moens M
AD  - 1Department of Neurosurgery, Universitair Ziekenhuis Brussel, Jette.
AD  - 2Center for Neurosciences (C4N), Vrije Universiteit Brussel, Jette.
AD  - 3STIMULUS Consortium (reSearch and TeachIng neuroModULation Uz bruSsel), 
      Universitair Ziekenhuis Brussel, Brussels.
AD  - 8Department of Radiology, Universitair Ziekenhuis Brussel, Jette, Belgium.
CN  - Discover Consortium
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20201218
PL  - United States
TA  - J Neurosurg Spine
JT  - Journal of neurosurgery. Spine
JID - 101223545
SB  - IM
MH  - Adult
MH  - Aged
MH  - Case-Control Studies
MH  - Cohort Studies
MH  - Failed Back Surgery Syndrome/complications/psychology/*therapy
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Quality of Life
MH  - Quality-Adjusted Life Years
MH  - Return to Work
MH  - *Spinal Cord Stimulation
MH  - Treatment Outcome
OTO - NOTNLM
OT  - cost-utility
OT  - health-related quality of life
OT  - high-dose spinal cord stimulation
OT  - lumbar
OT  - quality-adjusted life-years
OT  - work status
EDAT- 2020/12/19 06:00
MHDA- 2021/11/12 06:00
CRDT- 2020/12/18 20:17
PHST- 2020/05/01 00:00 [received]
PHST- 2020/07/15 00:00 [accepted]
PHST- 2020/12/19 06:00 [pubmed]
PHST- 2021/11/12 06:00 [medline]
PHST- 2020/12/18 20:17 [entrez]
AID - 10.3171/2020.7.SPINE20764 [doi]
PST - epublish
SO  - J Neurosurg Spine. 2020 Dec 18;34(3):440-448. doi: 10.3171/2020.7.SPINE20764.