Transcranial Magnetic Stimulation Improves Outcomes vs Sham for Failed Back Surgery Syndrome .
Effectiveness of Repetitive Transcranial Magnetic Stimulation in Patients With Failed Back Surgery Syndrome: A Double-Blind Randomized Placebo-Controlled Study
Pain Physician. 2021 Jan;24(1):E23-E30Twenty three patients with failed back surgery syndrome (FBSS) were randomized to undergo 2 weeks of repetitive transcranial magnetic stimulation (r-TMS; n=20) or sham treatment (n=20). Outcomes of interest include the following: pain evaluated using the Visual Analogue Scale (VAS) (i.e. resting VAS, VAS during activity, VAS at night), neuropathic pain evaluated using the Douleur Neuropathique 4 Questions (DN4), function evaluated using the Oswestry Disability Index (ODI), sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI), and depression evaluated using the Beck Depression Inventory (BDI). All outcomes were measured at 5 days, 10 days, 1 month, and 3 months follow-up. The results of this study demonstrated that VAS pain scores during activity was statistically significantly improved in the r-TMS group vs sham at 5 days, 10 days, and 1 month follow-up. Furthermore, DN4 scores were statistically significantly improved in the r-TMS group at 10 days and 1 month follow-up, but this was not sustained at 3 months follow-up. ODI, PSQI, and BDI scores were statistically significantly favored in the r-TMS group at 10 days follow-up, and BDI scores maintained this trend at 1 month and 3 months follow-up.
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