Patients' Expectations on Spinal Cord Stimulation for Failed Back Surgery Syndrome: A Qualitative Exploration

BACKGROUND: Spinal cord stimulation (SCS) is an effective therapy to reduce pain in patients who suffer from failed back surgery syndrome (FBSS). In order to inform patients optimally prior to this therapy, knowing their expectations is crucial.

METHODS: Thirteen patients suffering from FBSS and scheduled for SCS were interviewed using a semistructured protocol. Patients were interviewed either at home or at their treating hospital. Data from these interviews were analyzed using directed content analysis. In addition to the qualitative interviews, an adjusted Brief Pain Inventory questionnaire was used to quantify expectations.

RESULTS: The expectations of patients with regard to SCS could be subdivided into 13 categories, which could be grouped into 6 general themes: (1) physical well-being, (2) social well-being, (3) material well-being, (4) emotional well-being, (5) development and activity, and (6) constraints of the procedure of SCS. These findings confirm patients' expectations about the improvement of their quality of life by SCS for FBSS. This indicates that assessing pain relief is not enough to adequately evaluate the effects of SCS. The small diversity within the studied population and the lack of patient-to-patient education are 2 possible limitations of this study.

CONCLUSIONS: To improve education for patients prior to SCS surgery and to evaluate the effects of SCS, a multidimensional approach needs to be implemented. Possible disadvantages of SCS need to be discussed prior to the treatment.