Multiple lead spinal cord stimulation for chronic mechanical low back pain: a comparative study with intrathecal opioid drug delivery.

The objective of this paper is to assess the outcome of implanted multiple thoracolumbar lead spinal cord stimulation (SCS) in mechanical back pain without prior spinal surgery. These results are compared with intrathecal opioid drug delivery (ITDD). An anonymous third party patient questionnaire study of pain relief, function and psychosocial quality of life measures (recorded on 11-point numerical rating scales) for 12 patients with SCS and 13 with ITDD was used. Pain was significantly reduced with multiple lead SCS from a median of 9.0-6.5 (p < 0.01) and with ITDD from a median of 8.5-5.5 (p < 0.01). There was a trend towards greater reduction in pain in the ITDD group compared with the SCS group (pain differences 4.5 and 2.6, respectively) but this did not reach statistical significance. The majority of psychosocial quality of life measures were significantly more improved in the ITDD group compared with the SCS group (p < 0.05). We conclude that multiple-lead SCS improves mechanical back pain in patients unresponsive to more conservative measures. However, ITDD provides significantly more improved quality of life measures, with a trend towards greater pain reduction than SCS.