• Adnan Kasapovic, Yorck Rommelspacher, Sebastian Walter, Martin Gathen, and Robert Pflugmacher.
• Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland. adnan.kasapovic@ukbonn.de.
• Oper Orthop Traumatol. 2021 Aug 1; 33 (4): 364-373.

ObjectiveSpinal cord stimulation (SCS) targets structures of the dorsal column and dorsal horn of the spinal cord with electrical impulses, thereby, modulating pain perception. For chronic pain patients, e.g., in failed back surgery syndrome (FBSS), the aim is to achieve pain relief and enable patients to improve their quality of life.IndicationsFailed back surgery syndrome, complex regional pain syndrome (CRPS) type I and II, therapy-refractory ischemic pain, neuropathic pain syndromes (e.g., phantom limb pain).ContraindicationsIdentification of degenerative alterations as the cause of pain; untreated mental illness.Surgical TechniqueA two-stage implantation technique is performed. Initially, after percutaneous implantation of epidural leads a trial period with stimulation by an external pulse generator is evaluated. Following verification of pain relief, a subcutaneous internal pulse generator is implanted.Follow UpEarly mobilization and adjustment of stimulation parameters.ResultsIn all, 19 consecutive patients with FBSS were treated by high frequency SCS (HF-SCS) and included in a prospective prognostic study. In 18 patients, an internal pulse generator (IPG) for HF-SCS was permanently implanted. Therapy success was assessed using the Oswestry Disability Index (ODI), visual analogue pain scale (VAS) and painDetect questionnaire. Neuropathic pain of the legs versus the back (median values: VAS leg 71 mm, VAS back 69 mm) was dominant in the patients at a preoperative mean ODI of 63%. With HF-SCS therapy, a pronounced pain reduction was seen and persisted in the follow-up after 6 months (VAS leg 18 mm, VAS back 24 mm). The ODI showed an improvement to a mean of 24% after 6 months.© 2021. Springer Medizin Verlag GmbH, ein Teil von Springer Nature.

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