• Hanna Kaijankoski, Mette Nissen, Tiina-Mari Ikäheimo, Mikael von Und Zu Fraunberg, Olavi Airaksinen, and Jukka Huttunen.
• Department of Physical and Rehabilitation Medicine, Kuopio University Hospital (KUH), and Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
• Neurosurgery. 2019 Jun 1; 84 (6): 1225-1232.

BackgroundSpinal cord stimulation (SCS) has proven to be a cost-effective treatment for failed back surgery syndrome (FBSS). However, the effect on patients' working capability remains unclear.ObjectiveTo evaluate the impact of SCS on working capability and to identify the factors behind permanent disability in FBSS patients.MethodsThe study group consisted of 198 working-age patients with SCS trialed or implanted for FBSS in a single center between 1996 and 2014. For each patient, 3 living controls, matched by age, gender, and birthplace, were otherwise randomly selected by the Population Register Center. The data on working ability were obtained from the Social Insurance Institution. Patients were divided into 3 groups: SCS trial only, SCS implanted permanently, and SCS implanted but later explanted.ResultsA rehabilitation subsidy was given to 68 patients and 8 controls for a mean of 5.2 (95% confidence interval [CI] 2.4-8.2) and 0.2 (95% CI 0.05-0.6) days per month (P < .05). At the end of follow-up, 16 (37%), 13 (33%), 25 (22%), and 27 (5%) subjects were on disability pension (DP) in the SCS trial, SCS explanted, SCS permanent, and control groups. Patients in the SCS trial-only group were significantly more often on DP than were patients with permanent SCS (odds ratio 2.6; 95% CI 1.2-5.9; P = .02).ConclusionPermanent SCS usage was associated with reduced sick leave and DP. Prospective study will be required to assess possible predictive value.© Congress of Neurological Surgeons 2018.

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