The treatment of chronic back pain is a challenging and costly issue faced by patients across the United States. Spinal cord stimulators (SCS) or lumbar fusion surgery can be utilized in cases of intractable pain. This study aims to determine if a history of a thoracic SCS influences patient recorded outcomes measures (PROMs) of lumbar fusions at six months.
This retrospective cohort study includes patients who underwent elective lumbar fusions at Thomas Jefferson University Hospital between January 2018 and December 2019. PROMs were measured, specifically the Oswestry Disability Index (ODI), preoperatively and 6 months postoperatively. Clinical outcomes were broken down into substantial clinical benefit (SCB; ΔODI ≥ 10 points), minimal clinical important difference (MCID; ΔODI = 5-9 points), not reaching MCID (ΔODI = 1-4 points), no change, and worsening ODI. The Chi square test and Fisher exact test was used for categorical variables, and the student T test was used for continuous variables.
Of the 287 lumbar fusion patients, 17 had a thoracic SCS prior to lumbar fusion. There was no significant difference in the ΔODI between both cohorts. On average, the ODI improved by 6.7 points in the SCS group and 7.5 points in the non-SCS group (p=0.70). Additionally, there was no significant difference in the proportion of patients to reach MCID between cohorts.
Patients with a prior history of SCS are equally likely to benefit from lumbar fusions as those without. Therefore, the presence of an SCS should not impact the surgical decision making.
Recommended CitationBudlow, Jake; Hattar, Ellina; Patel, Heli; Montenegro, Thiago S.; Gonzalez, Glenn A.; Largoza, Garrett; Elia, Christopher; Matias, Caio M.; Wu, Chengyuan; Sharan, Ashwini D.; and Harrop, James S., "Clinical Outcomes Following Lumbar Fusion in Patients With and Without a History of Spinal Cord Stimulation Therapy" (2021). Phase 1. Paper 64.