A absence of evidence raises doubts about the advantages
People suffering from chronic back pain might consider spinal nerve stimulation in order to relieve their back pain, however an University of Sydney led Cochrane Review found no lasting advantages to the procedure which outweigh the costs and risk.
A spinal cord stimulation medical technique recommended to treat those suffering from chronic back discomfort, doesn’t offer long-term relief and could be harmful, according to an article in the Cochrane Review released today.
The stimulation of the spinal cord is believed to function through the planting of a device which sends electrical signals through the spinal cord in order to disrupt nerve signalling before they arrive at the brain.
The study examined the published clinical research regarding spinal stimulators for the spinal cord. The study included randomised controlled trials which are considered to be the most reliable method of evaluating the efficacy of a therapy in medical research.
Researchers analyzed data from 13 research trials studying the data of 699 participants which compared spinal cord stimulation with placebo or with no treatments for lower back pain.
Cochrane reviews are respected by medical professionals, researchers and policymakers for their solid methods to integrate information from numerous sources. This is which reduces the risk of random errors and bias that could make individual studies less credible.
The study found it was spinal cord stimulation is not superior to a placebo in managing low back pain. It is likely to provide very little or no benefit for patients suffering from low back discomfort or improving their level of living.
There was none of the clinical studies that examined the long-term effects for spinal motor stimulation which includes the potential for side reactions and possible complications.
The study also revealed adverse reactions to the procedure were not documented , which prevented them from determining the degree of risk. Damages resulting from spinal cord stimulation may be a result of nerve injury, infection as well as the electrical wires moving. All of these could require repeated surgeries.
The findings of the review have been presented for consideration by the Federal Department of Health and Aged Care prosthesis review taskforce. The taskforce is examining the current prostheses’ eligibility to be that are covered by Medicare.
In Australia the devices’ safety and performance are being utilized through the Therapeutic Goods Administration (TGA) which is the nation’s regulatory body for therapeutic goods.
“Spinal cord stimulation is an invasive procedure and can result in a huge financial burden for patients who opt for surgery as a last resort option to relieve their discomfort. Our study revealed that the long-term advantages and potential harms are not known,” said lead researcher Dr Adrian Traeger from Sydney Musculoskeletal Health part of Sydney Musculoskeletal Health, an initiative of the University of Sydney, Sydney Local Health District and Northern Sydney Local Health District.
“Our study of research data suggests that the benefits from the procedure outweigh the risks and costs..
“Low back pain is one of the main causes of disability across the world. Our findings also highlight the necessity of reviewing the financing arrangements for chronic pain treatment to assist patients seek relief. There are scientifically proven physical and mental treatments for back pain. Having that these are available is vital. .”
The review team discovered numerous gaps in the clinical data.
There are no studies that examined how long (more than 12 years) effects from spinal stimulators on lower back pain. The longest study was a six-month study.
A majority of trials focused on the immediate effects of the device. This is less than one month.
Review team made an outline of suggestions that include the need for the need for future spinal trial of stimulation for the spinal cord that must last minimum 12 months long, be able to clearly record the number of patients suffering from adverse events, and comparing them with other options for pain relief.
Prof. Chris Maher , Co-Director of Sydney Musculoskeletal Health, said,
“Our review revealed that the benefits of incorporating spinal nerve stimulation in order to alleviate low back pain is still unclear. If you consider the fact the fact that such devices can be expensive and can be damaged, there is certainly a problem this should be of interest to regulators. .”
A different Cochrane review that did not involve researchers were not part of the study in the study, looked at the effects the effects of spinal cord stimulation in comparison to placebo in patients suffering from chronic pain. Like this review, it concluded that there was no evidence suggesting that there are long-term benefits to managing chronic pain.
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