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Spinal Cord Stimulation for the Management of Neuropathic Pain in Failed Back Surgery Syndrome

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

Mohammed F. Shamji MD, PhD, FRCSC, Division of Neurosurgery, Toronto Western Hospital, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.

Alina Shcharinsky RN (EC), MN, CNN(C), Division of Neurosurgery, Toronto Western Hospital, Toronto, Ontario, Canada.

Abstract
Chronic pain is a complex disease state associated with substantial individual disability and suffering alongside societal economic impact. The entity of neuropathic pain is a diagnosis of specific clinical characteristics and underlying pathophysiology. Failed back surgery syndrome represents persistent neuropathic leg pain following structurally corrective spinal surgery, often being refractory to escalated pharmacological management. In appropriately selected patients, spinal cord stimulation is a surgical technique that may offer reduced disability and pain, and improved economic outcomes for patients where medical management has been unsuccessful. Contemporary technological advances continue to improve this approach with greater success, lessened morbidity, and expanding indications.
Key Words: failed back surgery syndrome, neuropathic pain, spinal cord stimulation, neuromodulation.