Spinal Cord Stimulators Adversely Affect Outcomes in Spinal Deformity Surgery. A Retrospective Case-Control Study

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Study Design Retrospective comparative analysis of prospective cohort. Objective To examine clinical outcomes of patients with preexisting SCS after adult spinal deformity surgery. Methods A total of 94 patients with and without a previous history of spinal cord stimulator placement undergoing surgery for ASD with minimum 2-year follow-up. Thirty-three patients with SCS undergoing ASD surgery with minimum 2-year follow-up were compared with a matched cohort of 61 ASD patients without SCS. Results Despite similar baseline ODI (56 vs 50, P = .11) and back VAS (6.8 vs 6.6, P = .52), SCS patients did worse at all post-op time intervals. At 6 months, the SCS cohort had higher ODI (48 vs 31, P < .001) and VAS (4.8 vs 3.5, P = .01). This difference persisted at 1 year for ODI (46 vs 30, P < .001) but not for VAS (4.7 vs 4.0, P = .19). At 2 years, ODI remained significantly worse in the SCS cohort (49 vs 38, P = .004). Both cohorts had significant improvement at 2 years compared to baseline (SCS: −1.6 VAS, P < .001, −7 ODI, P = .03; Control: −2.5 VAS, P < .001, −13 ODI, P < .001). Radiographic parameters such as curve magnitude, curve correction, and balance were similar between the 2 groups. Conclusion Despite having substantial improvement after ASD surgery, patients with previous SCS placement did significantly worse in both back VAS and ODI postop compared with controls. They also did not experience a decrease in narcotic use at 2 years despite having similar overall radiographic results and complication rates.

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