Our Cochrane review on spinal cord stimulators for #backpain out today.
Bottom line:
-Mod certainty evidence of no benefit vs placebo in medium term
-Uncertain if benefit on pain in immediate term
-Adverse events (infection, re-operation) common
cochranelibrary.com/cdsr/doi/10.10…
🧵
Although it looks like there is an effect in the immediate-term, the certainty of evidence was very low
When analysis on immediate term pain outcomes (<1mo - where most data were available) was restricted to studies with evidence of adequate blinding of participants, the effect disappeared
Evidence for medium term outcomes was based on one trial only. Hara trial (2022) showed no benefit of burst SCS vs placebo
Advocates will point to studies of SCS + medical management vs medical management alone. Some of those studies have results that are too good to be true. E.g:
The existing studies of SCS + medical management vs medical management should be interpreted with caution. We explain here
Important information for people with #backpain:
"No studies have tested whether spinal cord stimulation surgery is better than placebo (sham or 'dummy' treatment) in people followed up for longer than 6 months"
Mammoth team effort - many thanks to my co-authors @doctordoubter @CGMMaher and especially @SteveGilbert84
@msk_health @syd_health @CochraneMSK
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