@article{0ad08d10e04349a2b4daacd506741ad1,
title = "Two surgeries do not always make a right: Spinal cord stimulation for failed back surgery syndrome",
abstract = "Failed back surgery syndrome (FBBS†) is characterized by chronic pain that persists following spine surgery. In this review, we discuss the use of spinal cord stimulation (SCS) for FBBS treatment and how the clinical use of SCS may be influenced by private manufacturers. While SCS therapy can be promising for the appropriate patient, there remain knowledge gaps in understanding the full potential of SCS technology for delivering optimal therapeutic benefit. We caution that the use of SCS without a complete understanding of the technology may create exploitative situations that private manufacturers can capitalize on while subjecting patients to potentially unnecessary health and financial burdens.",
keywords = "Chronic pain, Failed back surgery syndrome, Neurosurgery, Spinal cord stimulation, Spine surgery",
author = "Duy, {Phan Q.} and Anderson, {William S.}",
note = "Funding Information: In addition to funding spine and SCS related research, the industry also provides significant financial support for continuing medical education (CME). In 2015, the industry provided $693 million of funding support for CME, according to the Accreditation Council for Continuing Medical Education [77]. Although a survey showed that the general population does not believe that the quality of their care would be diminished due to industrial funding of CME [78], a study of German CME courses demonstrated conflict of interest issues that resulted in biased educational curriculum that financially favored the funding source [79]. Funding Information: Recent trends indicate that clinical trials independently funded by the NIH are declining while those funded by industry are rising. Between 2006 and 2014, the number of industry-funded trials have increased by 43 percent, while the number of NIH-funded trials have decreased by 24 percent [67]. The growth of industry-financed clinical trials raises concerns regarding conflicts of interest, as the objectivity in research can be compromised by commercial interests. Indeed, a survey of 3,247 scientists showed that 15.5 percent admitted to changing the design, methodology or results of a study in response to pressure from a funding source [68]. Although the authors of the survey never asked respondents to distinguish between industry funding or independent funding, the number of industry-funded trials greatly outnumbered the number of NIH-funded trials (35.6 percent vs 5.7 percent of all trials registered in 2014) [67]. It is therefore likely that much of the pressure to alter the design or emphasis of the research studies was due to industry funding sources, especially with regards to studies that may impact financial interests of companies. Publisher Copyright: {\textcopyright} 2018, Yale Journal of Biology and Medicine Inc. All rights reserved.",
year = "2018",
month = sep,
language = "English (US)",
volume = "91",
pages = "323--331",
journal = "Yale Journal of Biology and Medicine",
issn = "0044-0086",
publisher = "Yale Journal of Biology and Medicine Inc.",
number = "3",
}