• Jaakko Määttä, Antti Martikainen, Tiina-Mari Ikäheimo, Mette Nissen, Heimo Viinamäki, Mikael von Und Zu Fraunberg, and Jukka Huttunen.
• Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.
• Neuromodulation. 2020 Jul 1; 23 (5): 646-652.

ObjectivesThe aim of the study is to investigate whether benzodiazepine use differs between patients with favorable and unfavorable spinal cord stimulation (SCS) treatment outcome. We hypothesize that the patients with unfavorable SCS outcome would exhibit a higher level of benzodiazepine use.Materials And MethodsUsing a case-control study setting, we examined benzodiazepine use in SCS patients and in matched population controls as a potential risk factor poor SCS outcome. A total of 373 consecutive SCS patients treated in Kuopio University Hospital between 1997 and 2014 and their 1117 matched population controls were followed until patient death or the end of March 2016.ResultsBenzodiazepines were used during the 24-month period before or after SCS implantation by 42.3% of the SCS patients who had the device explanted, 39.5% who had an unsuccessful trial stimulation, 28.0% who still had the device at the end of the follow-up period, and 8.0% of the controls. Diazepam use before SCS increased the odds for explanting of SCS by 2.4-fold (95% Cl: 1.0-5.4). Starting clonazepam use after SCS was associated with a 5.2-fold (95% CI: 1.5-18.9) increase in the odds of unsuccessful trial stimulation.ConclusionThe benzodiazepine use in patients with poor SCS outcome illustrates the role of anxiety in SCS outcomes and the need for multidisciplinary treatment of pain.© 2019 International Neuromodulation Society.

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