Does Spinal Cord Stimulation Due to Failed Back Surgery Syndrome Lead to Permanent Occupational Disability?

Szmuda, Tomasz; Słoniewski, Paweł; Ali, Shan; Aleksandrowicz, Katarzyna

doi:10.1111/ner.13014

Cited by 7 publications

(6 citation statements)

References 28 publications

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“…Apparently, representatives of neuromodulation device manufacturers expect an influence on the capacity to return to work, which is not an aspect that is supported by healthcare providers. A meta-analysis previously denoted that SCS results in a higher prevalence of patients at work compared with the situation before SCS (OR 2.15, 95% CI 1.44-3.21) [24]; however, the percentages of patients that effectively resumed work after SCS ranged between 10% [25] and 47% [26]. On the contrary, healthcare providers were more prone to select a reduction in pain medication use as a factor that is influenced by SCS, a finding that is completely in line with recent findings in the literature [27,28].…”

Section: Discussionmentioning

confidence: 99%

Goals, Expectations, and the Definition of Success for Neuromodulation for Pain According to Representatives of Neuromodulation Device Manufacturers

Moens

Alliet

Billot

et al. 2022

JPM

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Representatives of neuromodulation device manufacturers are expected to facilitate the relationship between patients and healthcare providers. Nevertheless, the goals, expectations, and definition of success for neuromodulation for pain have not yet been explored. Representatives present at the 2nd Joint Congress of the INS European Chapters in September 2021 completed a survey to ascertain their opinions about the goals to achieve with neuromodulation, the factors that they expect to change, and their definition of success for neuromodulation. In total, 39 representatives completed the survey. To provide excellent service for patients (22.4%), to become a trusted partner for physicians (21.5%), and to provide excellent service for physicians (20.7%) were the highest ranked goals. The most frequently reported factors that were expected to change were pain intensity (23.1%), patient satisfaction (19.7%), mobility/functioning (14.5%), and capacity to return to work (13.7%). Within the definitions of success, increased quality of life of the patient was stated in 21% of the definitions, closely followed by pain control (19.3%) and happiness/patient satisfaction (15.8%). The goals of representatives of neuromodulation device manufacturers seem to focus on ensuring a good relationship with physicians on the one hand and providing good service towards patients on the other hand, whereby pain control, quality of life, and patient satisfaction seem to be important for company representatives.

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Section: Discussionmentioning

confidence: 99%

Goals, Expectations, and the Definition of Success for Neuromodulation for Pain According to Representatives of Neuromodulation Device Manufacturers

Moens

Alliet

Billot

et al. 2022

JPM

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“…More specifically, the odds of being at work (OR 2.15; 95% CI 1.44-3.21; p<0.001) and returning to work (OR 29.06; 95% CI 9.73-86.75; p<0.001) were higher in patients post-SCS compared to before SCS. Despite the favourable results that SCS is an effective approach to stimulate RTW, in absolute numbers, only 9.5 to 14% of patients implanted with SCS are effectively returning to work [9][10][11]. Therefore, it seems that current post-operative interventions are not effective to achieve RTW after SCS implantation.…”

Section: Background and Rationale {6a}mentioning

confidence: 99%

Personalised rehabilitation to improve return to work in patients with persistent spinal pain syndrome type II after spinal cord stimulation implantation: a study protocol for a 12-month randomised controlled trial—the OPERA study

Moens

Goudman²,

Velde³

et al. 2022

Trials

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Background For patients with therapy-refractory persistent spinal pain syndrome type II (PSPS-T2), spinal cord stimulation (SCS) may serve as an effective minimally invasive treatment. Despite the evidence that SCS can improve return to work (RTW), only 9.5 to 14% of patients implanted with SCS are effectively capable of returning to work. Thus, it seems that current post-operative interventions are not effective for achieving RTW after SCS implantation in clinical practice. The current objective is to examine whether a personalised biopsychosocial rehabilitation programme specifically targeting RTW alters the work ability in PSPS-T2 patients after SCS implantation compared to usual care. Methods A two-arm, parallel-group multicentre randomised controlled trial will be conducted including 112 patients who will be randomised (1:1) to either (a) a personalised biopsychosocial RTW rehabilitation programme of 14 weeks or (b) a usual care arm, both with a follow-up period until 12 months after the intervention. The primary outcome is work ability. The secondary outcomes are work status and participation, pain intensity, health-related quality of life, physical activity and functional disability, functional capacities, sleep quality, kinesiophobia, self-management, anxiety, depression and healthcare expenditure. Discussion Within the OPERA project, we propose a multidisciplinary personalised biopsychosocial rehabilitation programme specifically targeting RTW for patients implanted with SCS, to tackle the high socio-economic burden of patients that are not re-entering the labour market. The awareness is growing that the burden of PSPS-T2 on our society is expected to increase over time due to the annual increase of spinal surgeries. However, innovative and methodologically rigorous trials exploring the potential to decrease the socio-economic burden when patients initiate a trajectory with SCS are essentially lacking. Trial registration ClinicalTrials.gov NCT05269212. Registered on 7 March 2022.

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“…A few studies have assessed the cost‐effectiveness balance of SCS, taking into account direct or indirect costs, 13,14,15 or both 16 . Economically, RTW status—thus decreasing indirect costs—is a critical variable analyzed by independent health technology assessment 17 . Although SCS is a well‐known effective treatment for reducing pain and improving quality of life, 5,18–20 little is known about the impact of SCS on occupational outcome parameters such as the RTW 21 .…”

Section: Introductionmentioning

confidence: 99%

“…16 Economically, RTW status-thus decreasing indirect costs-is a critical variable analyzed by independent health technology assessment. 17 Although SCS is a well-known effective treatment for reducing pain and improving quality of life, 5,[18][19][20] little is known about the impact of SCS on occupational outcome parameters such as the RTW. 21 RTW is a therapeutic goal, but it remains an undervalued outcome in medical research.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2023

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Objectives: Chronic 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 Methods: Among 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]). Results: The 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). Conclusions: Our 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. K E Y W O R D S failed back surgery syndrome, low back pain, return to work, spinal cord stimulation How to cite this article: Dauriac-Le Masson V, Gatt M-T, Chekroun C, Turak B, Djian MC. Spinal cord stimulation and return to work of patients with failed back surgery syndrome.

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Does Spinal Cord Stimulation Due to Failed Back Surgery Syndrome Lead to Permanent Occupational Disability?

Cited by 7 publications

References 28 publications

Goals, Expectations, and the Definition of Success for Neuromodulation for Pain According to Representatives of Neuromodulation Device Manufacturers

Goals, Expectations, and the Definition of Success for Neuromodulation for Pain According to Representatives of Neuromodulation Device Manufacturers

Personalised rehabilitation to improve return to work in patients with persistent spinal pain syndrome type II after spinal cord stimulation implantation: a study protocol for a 12-month randomised controlled trial—the OPERA study

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

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