Failed Back Surgery Syndrome Clinical Trial
Official title:
Comparison of Effectiveness of Tonic, High Frequency and Burst Spinal Cord Stimulation in Chronic Pain Syndromes: a Double-blind, Randomised, Cross-over, Placebo Controlled Trial
Spinal cord stimulation (SCS) is one of the most commonly undertaken neuromodulatory surgery
techniques in the treatment of neuropathic pain. The indication for SCS is an ineffective
conservative treatment of chronic pain syndromes. The effectiveness of SCS in the case of
neuropathic pain is high. The positive result of SCS treatment is the reduction of previous
painful symptoms by min. 50% and / or a reduction in the amount of taken analgesics and an
improvement in the quality of life including sleep quality. Long-term studies estimate that
in a properly selected group of patients more than 50% of patients achieve pain reduction by
the required 50% and about 60% - 70% have an improvement in the quality of life and a
reduction of pain.
The efficacy of SCS in different modes of stimulation is evaluated. Patients receive four
different types of stimulation for 2-week period - not knowing what kind of stimulation it
is. It is said that in one type of stimulation they would feel parestesias and in other three
they would not. Patients are not informed that beside tonic, burst and high frequency
stimulation, the fourth is an off stimulation to check for placebo effect. The test is
double-blinded
Patients with FBSS and CRPS are evaluated for VAS,, dissability scale, Quality of Life (QoL),
sleep disorders and mental disorders.
All patients undergo percutaneus (1 or 2) 8-contact SCS electrode implantation with trial.
All patients are blindly randomized to tonic or burst or high frequency or off stimulation.
After 2-week period each participant is adequately switched to another type of stimulation
for next 2 weeks. Alltogether crossover takes 8 weeks: four 2-week periods of tonic, burst,
HF and off stimulation. At the end of trial period patients are subjected to the mode of
stimulation which is the most efficent. The final 2-week stimulation is performed with final
renewed evaluation for VAS, amount of taken medications, dissability scale, Quality of Life
(QoL), sleep disorders and mental disorders. Follow-up observation will last up to 12 months.
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