Steven M. Falowski and Jason E. Pope (eds.)Integrating Pain Treatment into Your Spine Practice10.1007/978-3-319-27796-7_9

9. Integration of Specialties

Steven M. Falowski¹

(1)

Neurosurgery, St. Luke’s University Health Network, 701 Ostrum St, Suite 302, Bethlehem, PA 18017, USA

Steven M. Falowski

Email: sfalowski@gmail.com

Keywords

MultidisciplinarySpinal cord stimulationSpecialtiesReferralsPractice setupPain therapiesPatient selection

Key Points

Spinal cord stimulation (SCS) is a procedure that, in most cases, is considered minimally invasive, is performed as an outpatient same-day procedure, and has a very-low-risk profile.
SCS has class I evidence of its superiority when placed against conventional medical management and against repeat spinal surgery.
As a spine surgeon it is paramount to have a relationship with an interventional pain physician performing these procedures to foster the options for your patients or to offer the therapies in your practice.
Those involved in the multidisciplinary approach range and span beyond primary care physicians, pain management physicians, and spine surgeons.

Introduction

The treatment of chronic pain can be very challenging. As a spine surgeon it is important to be able to treat your patients throughout their disease process. A radiographic and technically successful surgery does not always translate into the patient results that one desires. It is known that at least 30–40 % of spine surgery patients will develop post-laminectomy syndrome/failed back surgery syndrome (FBSS) [1, 2]. The literature supports that SCS can produce at least 50 % pain relief in 50–60 % of the implanted patients and reduce the use of more medications [1]. Proper follow-up care is necessary to ensure maintenance and success of the therapy. Of most importance in the literature is that there is class I evidence in multiple trials to demonstrate the efficacy of SCS [1, 3]. It has been compared against best medical management as well as surgery [1, 3].

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