Spinal Cord Stimulation (SCS) is a medical therapy that employs electrical impulses to alleviate chronic pain and enhance the quality of life for individuals enduring various neurological and pain conditions. SCS operates by modulating the transmission of pain signals along the spinal cord, effectively “blocking” or interfering with the brain’s perception of pain. However, to date, little is known about the long-term effectiveness of the treatment.

Common indications for treatment with SCS are failed back surgery syndrome (FBSS), complex regional pain syndrome (CRPS), and neuropathic pain. Patients underwent a multidisciplinary evaluation, including clinical, radiological, electrophysiological, and psychological examinations. Patients can go through the trial phase with percutaneous insertion of the electrode or we can insert a surgical paddle electrode without the trial phase. Implantable pulse generators (IPG) are located in our cases in the subcutaneous pocket at the lateral part of the abdominal wall. After a successful trial phase implanted IPGs are usually rechargeable.

In UMC Maribor we inserted from 2003 to 2023 SCS in 53 patients, among them were 58.5% females and the mean age was 52.1±10.5 years. The most common indication was FBSS (88.7%). 50 (94.3%) patients have some kind of previous surgery, and the majority (42.3%) underwent two previous surgeries. After SCS VAS dropped an average of 4 points. The trial phase was in one-third of patients and its duration was on average 16±7.2 days. The average follow-up period was 6. 5 ± 5.8 years. At least one reimplantation was in 15 (28.3%) patients after 5.3 ± 3.96 years. Adverse events happened in 18 (34%) patients, among them were in decreasing order IPG problems, dysfunction of SCS, additional spine surgery, lead dysfunction, extension dysfunction, infection, or uncomfortable stimulation. SCS was removed by 7 (13.2%) patients after 3 ± 6.7 years (1 – 15 years), because of additional surgery, uncomfortable feeling, MRI, or infection. We have two infections of SCS on the side of percutaneous electrodes in the first months.

Results are comparable with other studies. Treatment with SCS for FBSS and neuropathic pain is effective when other treatment modalities are exhausted. Beside our studie, we are missing studies about long-terms (more than one year) effectiveness and adverse events of SCS.