Bio-psycho-social assessment of analgesic neuromodulation treatment in patients with failed back surgery syndrome (third part)
Abstract
Introduction: A significant number of patients with failed back surgery syndrome (FBSS) are so much debilitated that they are unable to return to work, suffer from unsolvable psychological and social difficulties and require a lot of pain killers, including strong opioids and other analgesic methods with often inadequate results. Neuromodulation analgetic methods have been successfully used in treatment of FBSS.
Multidisciplinary approach is important with cooperation of psychologist at any time. A variety of psychological and social factors had impact to the patient selection.
In this part of our study we wanted to find if neuromodulation treatment affects quality of life and disability in FBSS patients. Methods: Psychological assessment including certified psychological questionnaires has been used in thirty-six FBSS patients before and after neuromodulation treatment (Short form of the 36 Health survey questionnaire /SF 36/ and the Oswestry disability index /ODI/).
It was a prospective study. A paired-sample t-test was used for statistical evaluation.
Results: Significant improvement was observed in all eight items of SF 36: physical function, social function, physical limitation, emotional limitation, physical pain, vitality, mental health and general perception of health. Similar significant improvements were detected in these items of ODI: pain, walking, sitting, sleeping, social life and traveling.
Pain was significantly released in both SF 36 and ODI. Conclusions: FBSS belongs to severe disabled disease, both from a medical and social-economical view.
We observed significant improvement in quality of life, functional disability reduction and decrease in pain relief after introduction of neuromodulation treatment. Neuromodulation methods are efficacious in the treatment of FBSS patients, however, resposible selection is essential in all cases.