Abstract
Objectives
Various approaches have been developed with a view to treating the back pain component
in patients with chronic low back pain (CLBP) and persistent spinal pain syndrome
(PSPS). Emerging evidence shows that peripheral nerve field stimulation (PNFS) may
be an efficacious therapeutic modality against axial low back pain. Hence, the aim
of the review was to evaluate the analgesic efficacy and safety of PNFS, when used
alone or as an adjunct to spinal cord stimulation (SCS), for managing CLBP and PSPS.
Materials and Methods
A comprehensive search for clinical studies on PNFS and PNFS + SCS used for the management
of CLBP and/or PSPS was performed using PubMed, EMBASE, MEDLINE via Proquest, and
Web of Science.
Results
A total of 15 studies were included, of which four were randomized controlled trials
(RCTs), nine were observational studies, and two were case series. For patients receiving
PNFS, a significant decrease in back pain intensity and analgesic consumption, together
with a significant improvement in physical functioning, was observed upon implant
of the permanent system. Meanwhile, the addition of PNFS to SCS in refractory cases
was associated with a significant reduction in back and leg pain, respectively.
Conclusions
This review suggests that PNFS, when used alone or in combination with SCS, appears
to be effective in managing back pain. However, high-quality evidence that supports
the long-term analgesic efficacy and safety is still lacking. Hence, RCTs with a larger
patient population and of a longer follow-up duration are warranted.
Keywords
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Comments
Article info
Publication history
Published online: September 01, 2022
Accepted:
July 19,
2022
Received in revised form:
June 27,
2022
Received:
April 7,
2022
Footnotes
Source(s) of financial support: The authors reported no financial support for this research.
Conflict of Interest: The authors reported no conflict of interest.
Identification
Copyright
© 2022 Published by Elsevier Inc. on behalf of the International Neuromodulation Society.
