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Journal ArticleDOI

Treatment Options for Failed Back Surgery Syndrome Patients With Refractory Chronic Pain: An Evidence Based Approach

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TLDR
Clinicians may increasingly utilize levels of evidence during their evaluation of each FBSS patient to render the best therapeutic plan, likely resulting in improved long-term pain control and reducing costs by avoiding less effective modalities.
Abstract
Study Design.A significant number of lumbar postsurgical patients continue to suffer persistent pain and limited function and are termed to have “Failed back surgery syndrome” (FBSS). This review evaluates clinical trial data for the treatment of FBSS patients.Objective.Using an evidence-based appro

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Journal ArticleDOI

Discogenic Back Pain: Literature Review of Definition, Diagnosis, and Treatment.

TL;DR: The aim was to define discogenic back pain into a series of more specific and interacting pathologies, and to highlight the need to develop novel approaches and treatment strategies for this challenging and unmet clinical need.
Journal ArticleDOI

Prospective, Randomized Blind Effect-on-Outcome Study of Conventional vs High-Frequency Spinal Cord Stimulation in Patients with Pain and Disability Due to Failed Back Surgery Syndrome.

TL;DR: The evolutionary pattern of the different parameters studied in patients with FBSS does not differ according to their treatment by spinal stimulation, with conventional or high frequency, in one year follow-up.
Journal ArticleDOI

Spinal Cord Stimulation for the Treatment of Chronic Pain Reduces Opioid Use and Results in Superior Clinical Outcomes When Used Without Opioids.

TL;DR: Patients who eliminated opioid use or never used opioids had superior clinical outcomes to those who continued use and there was no difference between groups in revision or failure rates.
Journal ArticleDOI

Burst Spinal Cord Stimulation: A Clinical Review.

TL;DR: Clinical review on outcomes using burst spinal cord stimulation in the treatment of chronic, intractable pain shows burst SCS has been shown to be both statistically and clinically superior to tonic stimulation and may provide additional benefits through different mechanisms of action.
Journal ArticleDOI

A Systematic Review of Economic Evaluations Reporting the Cost-Effectiveness of Spinal Cord Stimulation

TL;DR: The results consistently suggest that SCS is cost-effective when considering a long-term time horizon, particularly for the management of FBSS and CRPS, and further studies are needed to assess the cost-effectiveness of SCS for ischemic pain and DPN.
References
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Journal ArticleDOI

CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016

TL;DR: This guideline is intended to improve communication about benefits and risks of opioids for chronic pain, improve safety and effectiveness of pain treatment, and reduce risks associated with long-term opioid therapy.
Journal ArticleDOI

Surgical versus Nonsurgical Therapy for Lumbar Spinal Stenosis

TL;DR: Patients who underwent surgery showed significantly more improvement in all primary outcomes than did patients who were treated nonsurgically, and the combined as-treated analysis showed a significant advantage for surgery by 3 months for allPrimary outcomes.
Journal ArticleDOI

Spinal cord stimulation versus repeated lumbosacral spine surgery for chronic pain: a randomized, controlled trial.

TL;DR: SCS is more effective than reoperation as a treatment for persistent radicular pain after lumbosacral spine surgery, and in the great majority of patients, it obviates the need for reoperation.
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