Open AccessAnalysis of Psychological Characteristics Impacting Spinal Cord Stimulation Treatment Outcomes: A Prospective Assessment
Author(s) -
Rui Duarte
Publication year - 2015
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.2015/18/e369
Subject(s) - medicine , oswestry disability index , visual analogue scale , hospital anxiety and depression scale , anxiety , physical therapy , pain catastrophizing , depression (economics) , prospective cohort study , mcgill pain questionnaire , coping (psychology) , chronic pain , psychological intervention , low back pain , surgery , psychiatry , alternative medicine , pathology , economics , macroeconomics
Background: Psychological factors are recognised as influencing the outcome of spinal cordstimulation (SCS) although there is currently no consensus as to which factors impact upon SCSefficacy.Objective: To identify psychological characteristics that may impact the efficacy of SCS.Study Design: Prospective evaluation.Setting: Single secondary care center in Dudley, United Kingdom.Methods: Patients: Seventy-five patients were initially recruited and 56 patients (31 womenand 25 men) were followed-up for 12-months. Intervention: SCS for the management of chronicnon-cancer pain. Main Outcome Measures: Outcome measures assessed at baseline, 6 months,and 12 months following SCS implantation included the visual analogue scale (VAS), Oswestrydisability index (ODI), hospital anxiety and depression (HAD) scale, and the pain coping strategiesquestionnaire (PCSQ).Results: Statistically significant improvements were observed for the VAS (P < 0.001), ODI (P =0.011), anxiety (P = 0.042), and depression (P = 0.010) in the HAD scale and for the subscalesreinterpreting pain sensation (P = 0.018), control over pain (P = 0.001), and ability to decrease pain(P < 0.001) of the PCSQ. We observed that depression and autonomous coping (control over pain,ability to reduce pain, and catastrophizing) may impact sensory aspects such as pain intensity anddisability scores affecting the outcome of SCS treatment. Age at time of implant and duration ofpain prior to implant were also found to impact SCS efficacy.Limitations: It has been reported that loss of analgesia may be experienced within 12 to 24months following SCS implantation and therefore, it would be of interest to follow patients overa longer period.Conclusions: This study demonstrates that psychological aspects such as depression andautonomous coping may impact SCS treatment. Addressing these issues prior to SCS implantationmay improve SCS long-term outcome.Key words: Spinal cord stimulation, chronic pain, psychological characteristics, depression,autonomous coping