Failed Back Surgery Syndrome Clinical Trial
Failed back surgery syndrome (FBSS) constitutes a frequent pathology, generates a severe
handicap for patients and represents a considerable expense for healthcare system.
Neurostimulation has currently not been validated in the treatment of back pain because of
technological limitations in implantable spinal cord stimulation (SCS). The lack of a
validated technique for back pain relief has prompted the development of newer devices,
including leads with increased number of contacts (up to 16) and various geometric
arrangements, the objective of which is to cover a larger area while attempting to extend,
steer, or focus the electric field of the stimulation within the spinal cord regions. This
led companies to design a new generation of multicolumn surgical leads that allow the
activation of longitudinal and transverse electric fields (multicolumn spinal cord
stimulation, MSCS) in order to provide bilateral paresthesia coverage of back pain.
The objective of this study is to compare the analgesic efficacy of MSCS (using longitudinal
and transverse electric stimulation) versus mono-column spinal cord stimulation (CSCS, using
axial stimulation, actually represented by quadripolar or octopolar lead) on the treatment
of lumbar pain.
A total of 115 patients will be randomized to either CSCS or MSCS. Patients, between 18 and
80 years old suffering from refractory neuropathic pain of radicular origin with associated
back pain will be included. Patients will be divided into two groups. One group with MSCS
during the 12 months after the new generation electrode implantation and one group with CSCS
during 6 months and MSCS between 6 and 12 months after the new generation electrode
implantation.
The following parameters will be evaluated during this study: overall pain VAS, leg pain
VAS, back pain VAS, Oswestry disability index, Montgomery and Asberg Depression Rating
scale, Brief Anxiety Scale and the Euro Quality of Life-5 Dimension Health questionnaire and
costing in relation to surgery and patient management.
n/a
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
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