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Objectives   We investigated the influence of spinal cord stimulation (SCS) on IFN- γ , IL-1 β , IL-6, TNF- α , IL-10, and TGF- β  serum levels in failed back surgery syndrome (FBSS) patients. The study will try to give new insights into the mechanism of SCS action and the role of IFN- γ  and other cytokines in neuropathic pain (NP) development.Materials and Methods   Clinical and biochemical assessment was conducted in four groups of patients:  group 0  consisted of 24 FBSS patients qualified to SCS therapy,  group 1  included 17 patients who were one month after implantation,  group 2  featured 12 patients who were 3 months after the implantation, and  group C  (the control group) with no NP. Clinical status was assessed with the use of Numeric Rating Scale (NRS), the Pain Rating Index of McGill Pain Questionnaire (SF-MPQ), the Oswestry Disability Index (ODI), and Beck Depression Inventory (BDI). The plasma concentrations of IFN- γ  were ascertained by an immunoenzymatic method.Results   We found a significant difference between the patients before SCS and controls' serum level of IFN- γ . Similarly, a significantly higher level of TNF- α  and significantly lower level of IL-10 in FBSS patients than controls were observed. The significant differences were not observed between SCS patients 3 months after the procedure and controls' serum level of IFN- γ  and other cytokines. We noticed a positive correlation between IFN- γ  concentration with NRS back value before SCS and positive correlation between IFN- γ  concentration after SCS with NRS leg value before SCS. Higher IFN- γ  concentrations accompanied higher NRS values. Levels of TGF- β  and IL-10 may correlate with physical ability and depressive behavior.Conclusions   SCS did not influence serum cytokine levels significantly. Serum concentration of IFN- γ  may be recognized as an occasional pain factor because of its significantly higher level in FBSS patients versus controls and higher IFN- γ  value accompanying higher pain intensity.

The Elevated Serum Level of IFN-γ in Patients with Failed Back Surgery Syndrome Remains Unchanged after Spinal Cord Stimulation