• Claudio Reverberi, Alessandro Dario, and Giancarlo Barolat.
• Pain Therapy Department, Oglio-Po Hospital, Casalmaggiore, Italy. c.reverberi@gmail.com
• Neuromodulation. 2013 Jan 1;16(1):78-82; discussion 83.

BackgroundFailed back surgery syndrome (FBSS) is a well-defined pathologic condition observed over many years.DesignWe have investigated the effect of spinal cord stimulation (SCS) with peripheral nerve field stimulation (PNfS) in eight patients with FBSS.Outcome MeasureThe following parameters were collected and analyzed: The pain intensity score on a 0-10 numbering rating scale (NRS), the psychologic profile with Beck Depression Inventory (BDI), the pain quality with McGill Pain Questionnaire-short form (MGPQ-sf), the back pain with Oswestry scale score (OS), and the health general quality pattern with QualityMetric's SF-36v2(®) Health Survey.PatientsEight patients with low back and radicular pain in FBSS are reported. The mean duration of pain was 6.7 months, and the mean NRS score was 9.5, BDI 28.8, MGPQ-sf 16.8, OS 44.5, and SF-36 score was 72.8. The average drug intake of opioids was 250 mg/day.InterventionIn six patients, two octopolar leads were placed in epidural space at D7-D8 and D8-D9, in conjunction with two octopolar leads placed in lumbar-sacral subcutaneous space (Precision System, Boston Scientific, Valencia, CA, USA), and in two patients, a two tetrapolar leads was placed in epidural space at D8-D9 with two tetrapolar leads (Pisces Quad, Plus, Medtronic Inc., Minneapolis, MN, USA) placed in lumbar-sacral subcutaneous space (Restore Ultra, Medtronic Inc., Minneapolis, MN, USA).ResultsAfter one year mean of follow-up, the mean NRS score was 4, BDI 8, MGPQ-sf 5, OS 21, and the SF-36 score was increased at 108.5. The mean drug intake of opioids was decreased at 20 mg/day.ConclusionThe combination of SCS and PNfS, using the latest rechargeable systems, may be a valid therapeutic strategy in FBSS.© 2012 International Neuromodulation Society.

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