Background and aims

Recent literature reports a correlation between chronic opioid use and an unfavorable SCS outcome for failed back surgery syndrome (FBSS). However SCS can also successfully reduce or stabilize opioid use [1-3]. We investigated the effect of SCS on the opioid use in a single pain center.

Methods

The record files of 125 patients were retrospectively evaluated. Daily morphine milligram equivalents (MME) were calculated. Patients were regarded as receiving a high dose if they used more than 90 mg MME a day (HM), all others were regarded as receiving low dose (LM)
Medication use was assessed at three points in time: 12 months before SCS implantation (T0), on the day of SCS implantation (T1) and one month after SCS implantation (T2). A double-sided repeat ANOVA measurement was performed on the dataset. 

Results

Out of the 46, who were using strong opioids at the time of SCS implantation, 14 were able to cease using opioids one month after implantation.
A significant reduction on medication use after SCS was noted over all groups over time (p<0,0001). 
In the LM group a reduction from 23,8 mg MME at implantation to 10,7 mg MME after implantation was seen. The largest effect was observed in the group on high dose opioids (HM), a significant reduction in dose was noted from 178,4 mg MME (T1) to 103,3 mg MME (T2).

Conclusions

There was a significant reduction in opioid usage after implantation. The greatest reduction was recorded in het HM group.

THE EFFECT OF SPINAL CORD STIMULATION ON OPIOID USE