Spinal cord stimulation/neurostimulation: an accelerated systematic review

Middleton P, Simpson B, Maddern G
Record ID 32004000656
Authors' objectives:

To assess the effectiveness and safety of spinal cord stimulation (neurostimulation).

Authors' results and conclusions: SCS was more effective in terms of pain relief or reducing anginal attacks when compared with placebo or delayed implantation, but no difference was seen in the comparisons with CABG or switching SCS on and off in the same patient. For critical limb ischaemia, SCS was more effective in relieving pain than analgesia alone, but no difference was seen when SCS plus best medical treatment was compared with best medical treatment alone. For complex regional pain syndrome, SCS was more effective in relieving pain than physiotherapy, but no difference was seen between SCS and placebo for painful diabetic neuropathy. The most reported complications were electrode or lead displacements, which required reintervention and repositioning, although these complications are decreasing as the technology improves. A small number of implant and battery failures have been noted, as has one duodenal perforation and two dural punctures. Infection at the implant site seems to be relatively common.
Authors' recomendations: SCS was shown to be effective in relieving pain in only some of the included studies, but the small patient numbers may have limited the ability of studies to detect clinically important differences. SCS appears to be relatively safe, although the long-term safety and effectiveness of SCS have not yet been evaluated.
Authors' methods: Systematic review
Project Status: Completed
Year Published: 2003
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Australia
MeSH Terms
  • Electric Stimulation Therapy
  • Spinal Cord
  • Pain
Organisation Name: Australian Safety and Efficacy Register of New Interventional Procedures-Surgical
Contact Address: ASERNIP-S PO Box 553, Stepney SA 5069 Australia Tel: +61 8 8363 7513; Fax: +61 8 8362 2077;
Contact Name: college.asernip@surgeons.org
Contact Email: college.asernip@surgeons.org
Copyright: Australian Safety and Efficacy Register of New Interventional Procedures - Surgical
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.