LAUSR

BACKGROUND Recurrent and chronic low back pain, caused by degenerative lumbar spondylosis, commonly affect old aged patients, even with no low back previous surgeries. These patients may become, as those affected by FBSS, unresponsive to medical conservative treatment and their quality of life could be easily compromised. Moreover, general comorbidities, obesity and other typical old-age conditions, may make potential surgeries under general anesthesia riskier than the natural history of the diseases. These patients could be considered affected by the "SBRS", surgical back risk syndrome. METHODS In this report we present our preliminary observational prospective study on the role of SCS on three groups of patients: FBSS group, SBRS group and "Other" group. Selection criteria, treatment modality and outcomes for each patient group were described and discussed. Moreover a potential useful diagnostic and therapeutic flowchart on the management options for lumbar back pathologies is discussed. RESULTS FBSS included 25 patients, SBRS group included 10 patients, "other" group included 3 patients. In 22/25 patients with FBSS (88% of total) the implantation of definitive neurostimulator was successful. In almost total of patients in both groups SBRS and "other" the implantation of definitive neurostimulator was successful. CONCLUSIONS In our opinion, SCS could be considered as a valid alternative treatment not only in selected patient affected by FBSS but also in selected patients affected by SBRS, where back surgery under general anesthesia may be very challenging and overcome the potential benefit of the surgery itself. SBRS could be considered a new pathology entity to be managed through the SCS.