Objective

Low back pain is the leading cause of disability worldwide and one of the most common reasons for seeking health care. Despite numerous care strategies, patients with low back pain continue to exhibit poor outcomes. Spinal cord stimulation (SCS) is an evidence-based therapeutic modality for patients with failed back surgery syndrome. For patients without a surgical lesion or history, minimally invasive interventions that provide long-term reduction of chronic back pain are needed. Therefore, we conducted a systematic review of the evidence on SCS therapy in patients with chronic back pain who have not undergone spinal surgery.

Materials and Methods

A systematic literature search was performed to identify studies reporting outcomes for SCS in chronic back pain patients (with or without secondary radicular leg pain) without prior surgery using date limits from database inception to February 2021. Study results were analyzed and described qualitatively.

Results

A total of ten primary studies (16 publications) were included. The included studies consistently demonstrated favorable outcomes in terms of pain reduction and functional improvement following SCS therapy. Improvements also occurred in quality of life scores; however, not all studies reported statistically significant findings. Additionally, the studies reported that SCS resulted in high patient satisfaction, reductions in opioid use, and an acceptable safety profile, although these data were more limited.

Conclusion

Findings suggest that SCS is a promising, safe, minimally invasive, and reversible alternative option for managing chronic back pain in patients who have not undergone spinal surgery.

中文翻译：

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未进行脊柱手术的慢性背痛患者脊髓刺激的系统文献综述

 客观的

腰痛是全世界残疾的主要原因，也是寻求医疗保健的最常见原因之一。尽管采取了多种护理策略，腰痛患者的治疗效果仍然不佳。脊髓刺激（SCS）是针对背部手术失败综合征患者的一种循证治疗方式。对于没有手术病变或病史的患者，需要采取微创干预措施来长期减轻慢性背痛。因此，我们对未接受脊柱手术的慢性背痛患者进行 SCS 治疗的证据进行了系统回顾。

 材料和方法

我们使用从数据库建立到 2021 年 2 月的日期限制，进行了系统性文献检索，以确定报告慢性背痛患者（伴有或不伴有继发性根性腿痛）的 SCS 结果的研究。研究结果进行了定性分析和描述。

 结果

总共纳入了 10 项初步研究（16 篇出版物）。纳入的研究一致证明 SCS 治疗后在减轻疼痛和改善功能方面取得了良好的结果。生活质量评分也有所改善；然而，并非所有研究都报告了具有统计学意义的结果。此外，研究报告称，SCS 带来了较高的患者满意度、阿片类药物使用的减少以及可接受的安全性，尽管这些数据较为有限。

 结论

研究结果表明，SCS 是一种有前途、安全、微创且可逆的替代选择，用于治疗未接受脊柱手术的患者的慢性背痛。