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Pain Med. 2018 Feb 1;19(2):385-392. doi: 10.1093/pm/pnx060.

The Effectiveness of an Intensive Interdisciplinary Pain Rehabilitation Program in the Treatment of Post-Laminectomy Syndrome in Patients Who Have Failed Spinal Cord Stimulation.

Author information

1
Department of Pain Medicine, Mayo Clinic, Jacksonville, Florida, USA.

Abstract

Introduction:

Post-laminectomy syndrome (PLS) patients who have previously undergone spinal cord stimulation and failed to have significant improvement create a unique challenge for ongoing pain management. We hypothesize that, following successful completion of intensive, interdisciplinary pain rehabilitation (IPR), this patient population can achieve a significant reduction in pain, improvement in mood, functional levels, and self-efficacy.

Materials and methods:

A retrospective chart review was conducted comparing the following for patients prior to enrollment in the IPR program and upon completion: numeric rating scale (NRS) pain scores; functional status via the six-minute walk test; mood via the Center for Epidemiologic Studies Depression Scale (CES-D), Multidimensional Pain Inventory (MPI) Life control scores and MPI Interference, and the Pain Catastrophizing Scale (PCS); and self-efficacy via the Pain Self-Efficacy Questionnaire (PSEQ).

Results:

Forty-three patients met inclusion criteria, with 17 males and 26 females and a mean age of 64 years. Patients demonstrated a statistically significant increase in six-minute walk test distance of 104 m, a decrease in average NRS pain score of 1.4 points, an increase in average MPI life control by 8.3 points, a decrease average MPI interference by 5.3 points, an increase in average Short Form-36 by 6.5 points, an increase in average PCS by 4.4 points, and an increase in average PSEQ score of 18.1. Their average mood via CES-D improved by 4.2 points.

Conclusions:

Intensive, interdisciplinary pain rehabilitation provides an effective therapeutic modality for patients with post-laminectomy syndrome who have failed spinal cord stimulation by decreasing pain levels and by increasing functional status and self-efficacy.

KEYWORDS:

Intensive Interdisciplinary Pain Rehabilitation Program (IPR); Multidimensional Pain Inventory; Pain Catastrophizing Scale; Pain Self-Efficacy Questionnaire; Post-Laminectomy Syndrome; Spinal Cord Stimulation

PMID:
28402524
DOI:
10.1093/pm/pnx060
[Indexed for MEDLINE]

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