Intrathecal drug delivery for treatment of chronic low back pain: report from the National Outcomes Registry for Low Back Pain

Pain Med. 2004 Mar;5(1):6-13. doi: 10.1111/j.1526-4637.2004.04011.x.

Abstract

Objective: To obtain data on patient demographics, clinical practices, and long-term outcomes for patients with chronic low back pain treated with implantable drug-delivery systems.

Design: The National Outcomes Registry for Low Back Pain collected data at baseline, trialing, implant (or decision not to implant), and at 6- and 12-month follow-ups. Data were collected at all time points, regardless of implant status.

Outcome measures: Numeric pain ratings and Oswestry Low Back Pain Disability scores from implanted patients were compared among baseline and 6- and 12-month follow-ups. Patients were also asked to rate their quality of life and satisfaction with the therapy.

Results: Thirty-six physicians enrolled 166 patients to be trialed for drug-delivery systems. The trialing success rate was 93% (154 patients). In all, 136 patients (82%) were implanted. In the implant group, numeric pain ratings dropped by more than 47% for back pain and more than 31% for leg pain at the 12-month follow-up. More than 65% of implanted patients reduced their Oswestry scores by at least one level at their 12-month follow-ups compared with baseline. At 12-month follow-ups, 80% of implanted patients were satisfied with their therapy and 87% said they would undergo the procedure again.

Conclusions: Current clinical practices related to trialing of drug-delivery systems resulted in the majority of patients successfully trialed. At 12-month follow-ups, implanted patients experienced reductions in numeric back and leg pain ratings, improved Oswestry scores, and high satisfaction with the therapy.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesics, Opioid / administration & dosage*
  • Chronic Disease
  • Drug Delivery Systems / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Infusion Pumps, Implantable*
  • Injections, Spinal
  • Low Back Pain / drug therapy*
  • Low Back Pain / psychology
  • Male
  • Middle Aged
  • Pain Measurement / drug effects
  • Pain Measurement / psychology
  • Patient Satisfaction
  • Registries*
  • Treatment Outcome

Substances

  • Analgesics, Opioid