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December 10, 2001

Levy: Spine stimulation can help
low-back pain

By Janet Christenbury


Could a small device implanted under the skin be the answer for thousands of patients suffering from persistent leg and back pain following lower-back surgery?

Doctors at Emory are trying to determine if spinal cord stimulation—rather than more surgery—can be an effective treatment for patients with a condition called Failed Back Surgery Syndrome. The new study, recently under way at the Emory Spine Center, is the first of its kind to compare two treatments for chronic low-back and leg pain: spinal cord stimulation and repeat spine surgery.

“Spinal cord stimulation works by blocking pain signals from reaching the brain,” said Howard Levy, assistant professor of orthopaedics and principal investigator of the two-year trial. “The device is implanted in the lower back and wires, or leads, connected to the device are run into the spinal canal. Once the device is in place, patients can turn it on and off with the touch of a magnet.”

Approximately 200,000 Americans annually undergo an initial spine surgery for the treatment of low-back and leg pain, according to a 1998 survey of spine surgeons. The same research indicates that about 25 percent of these patients continue to experience unresolved pain after surgery. And, despite a second procedure to relieve the pain, more than 13,000 patients still suffer from unresolved pain.

Participants in the trial will be randomized; some will be implanted with the spinal cord stimulator, while some will undergo a second spinal surgery.

“In the end, the study is expected to tell us which treatment option provides reduced pain, greater functional status, improved quality of life and reduced disability to patients with chronic lower back and leg pain,” Levy said.

Participants in the study must be 20 years or older and must meet the following criteria: previous back surgery more than a year prior to enrollment, failure of alternative treatment measures (such as medical or physical therapies), and disabling pain that has limited their social and vocational activities.

As with any treatment, side effects can occur. Because spinal cord stimulation systems are surgically placed, infections are possible. Potential complications from spinal cord stimulation may include undesirable changes in stimulation, lead migration and loss of pain-relieving effects in some patients. Since spine surgery involves the nervous system, nerve damage is another risk. Both spinal cord stimulation and reoperation are standard medical procedures used to treat chronic pain.

Emory is one of 11 sites participating in this study, funded by the National Spine Network, based in Marietta. To learn more about this study, call the Emory Spine Center at 404-778-7000.


Back to Emory Report December 10, 2001