{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T01:30:47Z","timestamp":1793151047211,"version":"4.5.0"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Given the ubiquity and severity of postoperative pain following spine surgery, developing adequate pain management modalities is critical. Transcutaneous electrical nerve stimulation (TENS) is a promising noninvasive modality that is well studied for managing postoperative pain following a variety of surgeries, but data on using TENS for pain management in the acute postoperative period of spine surgery are limited. Therefore, this review aimed to recapitulate the existing evidence for the use of TENS in postoperative pain management for spine surgery and explore the potential of this modality moving forward.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A scoping review was conducted according to 2020 PRISMA guidelines. Two independently operating reviewers then conducted a systematic search of PubMed, Embase, and Scopus databases to identify studies that reported the use of TENS for the treatment of acute postoperative pain following spine surgery. The following data were abstracted from included studies: study type, sample size, demographics, surgery details, comparison group, assessment parameters, timing of postoperative assessment, TENS technical characteristics, relevant findings, length of hospital stay, complications with TENS, and notable limitations.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Nine hundred thirty-two publications were screened, resulting in 6 studies included in this review, all of which were prospective clinical trials. The publication dates ranged from 1980 to 2011. Spine surgery types varied; the most common was posterior lumbar interbody fusion. No studies evaluated pain control in cervical- or thoracic-only surgeries. All 6 studies evaluated the level of postoperative pain directly. Five of the 6 studies that directly examined postoperative pain reported lower levels of pharmacological analgesia usage in the TENS groups compared with controls, with 4 of these studies reporting this difference as statistically significant. Length of hospital stay was evaluated in 2 studies, both of which reported decreases in mean length of stay, but these differences were not significant. Notably, every study reported distinct TENS administration parameters while also reporting similar results.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>This review concludes that TENS is effective at reducing postoperative pain in spine surgery. Further investigation is needed regarding the optimal settings for TENS administration, as well as efficacy in the thoracic and cervical spine.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.1.spine231079","type":"journal-article","created":{"date-parts":[[2024,4,13]],"date-time":"2024-04-13T02:00:01Z","timestamp":1712973601000},"page":"97-104","source":"Crossref","is-referenced-by-count":8,"title":["Transcutaneous electrical nerve stimulation for the treatment of acute postoperative pain following spine surgery: a scoping review"],"prefix":"10.3171","volume":"41","author":[{"given":"John H.","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaes C.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel S.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob R.","family":"Joseph","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5","key":"b1","series-title":"J Clin Anesth","first-page":"349","article-title":"Retrospective evaluation of unanticipated admissions and readmissions after same day surgery and associated costs","volume":"14","author":"Coley KC","year":"2002","unstructured":"Coley KC, Williams BA, DaPos SV, Chen C, Smith RB. Retrospective evaluation of unanticipated admissions and readmissions after same day surgery and associated costs. J Clin Anesth. 2002;14(5):349\u2013353."},{"issue":"1","key":"b2","series-title":"Anesthesiol Clin North America","first-page":"21","article-title":"Consequences of inadequate postoperative pain relief and chronic persistent postoperative pain","volume":"23","author":"Joshi GP","year":"2005","unstructured":"Joshi GP, Ogunnaike BO. Consequences of inadequate postoperative pain relief and chronic persistent postoperative pain. Anesthesiol Clin North America. 2005;23(1):21\u201336."},{"issue":"2","key":"b3","series-title":"Anaesthesia","first-page":"179","article-title":"A review of enhanced recovery for thoracic anaesthesia and surgery","volume":"68","author":"Jones NL","year":"2013","unstructured":"Jones NL, Edmonds L, Ghosh S, Klein AA. A review of enhanced recovery for thoracic anaesthesia and surgery. Anaesthesia. 2013;68(2):179\u2013189."},{"issue":"3","key":"b4","series-title":"Pain","first-page":"303","article-title":"The impact of post-operative pain on outcomes following hip fracture","volume":"103","author":"Morrison SR","year":"2003","unstructured":"Morrison SR, Magaziner J, McLaughlin MA,  The impact of post-operative pain on outcomes following hip fracture. Pain. 2003;103(3):303\u2013311."},{"issue":"9","key":"b5","series-title":"Osteoarthritis Cartilage","first-page":"1257","article-title":"Acute postoperative pain following hospital discharge after total knee arthroplasty","volume":"21","author":"Chan EY","year":"2013","unstructured":"Chan EY, Blyth FM, Nairn L, Fransen M. Acute postoperative pain following hospital discharge after total knee arthroplasty. Osteoarthritis Cartilage. 2013;21(9):1257\u20131263."},{"issue":"4","key":"b6","series-title":"Anesth Analg","first-page":"1078","article-title":"The effect of pain on health-related quality of life in the immediate postoperative period","volume":"97","author":"Wu CL","year":"2003","unstructured":"Wu CL, Naqibuddin M, Rowlingson AJ, Lietman SA, Jermyn RM, Fleisher LA. The effect of pain on health-related quality of life in the immediate postoperative period. Anesth Analg. 2003;97(4):1078\u20131085."},{"issue":"3","key":"b7","series-title":"Ann Surg","first-page":"487","article-title":"Somatic and psychologic predictors of long-term unfavorable outcome after surgical intervention","volume":"245","author":"Peters ML","year":"2007","unstructured":"Peters ML, Sommer M, de Rijke JM,  Somatic and psychologic predictors of long-term unfavorable outcome after surgical intervention. Ann Surg. 2007;245(3):487\u2013494."},{"key":"b8","series-title":"Agency for Healthcare Research and Quality;","article-title":"Trends in Operating Room Procedures in U.S. Hospitals, 2001\u20132011. Healthcare Cost and Utilization Project (HCUP) Statistical Brief #171","author":"Weiss AJ","year":"2014","unstructured":"Weiss AJ, Elixhauser A. Trends in Operating Room Procedures in U.S. Hospitals, 2001\u20132011. Healthcare Cost and Utilization Project (HCUP) Statistical Brief #171. Agency for Healthcare Research and Quality; 2014.Accessed February 15, 2024.http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK201926\/"},{"key":"b9","series-title":"Clin Neurol Neurosurg","first-page":"37","article-title":"Management of postoperative pain after lumbar surgery-pregabalin for one day and 14 days-a randomized, triple-blinded, placebo-controlled study","volume":"151","author":"Zarei M","year":"2016","unstructured":"Zarei M, Najafi A, Mansouri P,  Management of postoperative pain after lumbar surgery-pregabalin for one day and 14 days-a randomized, triple-blinded, placebo-controlled study. Clin Neurol Neurosurg. 2016;151:37\u201342."},{"issue":"1","key":"b10","series-title":"Anesthesiology","first-page":"226","article-title":"Incidence, reversal, and prevention of opioid-induced respiratory depression","volume":"112","author":"Dahan A","year":"2010","unstructured":"Dahan A, Aarts L, Smith TW. Incidence, reversal, and prevention of opioid-induced respiratory depression. Anesthesiology. 2010;112(1):226\u2013238."},{"issue":"3","key":"b11","series-title":"Ann Pharmacother","first-page":"400","article-title":"Opioid-related adverse drug events in surgical hospitalizations: impact on costs and length of stay","volume":"41","author":"Oderda GM","year":"2007","unstructured":"Oderda GM, Said Q, Evans RS,  Opioid-related adverse drug events in surgical hospitalizations: impact on costs and length of stay. Ann Pharmacother. 2007;41(3):400\u2013406."},{"issue":"1","key":"b12","series-title":"Pain Med","first-page":"35","article-title":"The prevalence, severity, and impact of opioid-induced bowel dysfunction: results of a US and European Patient Survey (PROBE 1)","volume":"10","author":"Bell TJ","year":"2009","unstructured":"Bell TJ, Panchal SJ, Miaskowski C, Bolge SC, Milanova T, Williamson R. The prevalence, severity, and impact of opioid-induced bowel dysfunction: results of a US and European Patient Survey (PROBE 1). Pain Med. 2009;10(1):35\u201342."},{"issue":"1","key":"b13","series-title":"Rev Pain","first-page":"7","article-title":"Transcutaneous electrical nerve stimulation: mechanisms, clinical application and evidence","volume":"1","author":"Johnson M","year":"2007","unstructured":"Johnson M. Transcutaneous electrical nerve stimulation: mechanisms, clinical application and evidence. Rev Pain. 2007;1(1):7\u201311."},{"key":"b14","article-title":"Transcutaneous electrical nerve stimulation. In: StatPearls","author":"Teoli D","year":"2023","unstructured":"Teoli D, An J. Transcutaneous electrical nerve stimulation. In: StatPearls. StatPearls Publishing;2023.Accessed February 15, 2024.http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK537188\/"},{"issue":"2","key":"b15","series-title":"Pain Manag","first-page":"87","article-title":"The effect of transcutaneous electrical nerve stimulation on pain and electrical stimulation muscle thickness in patients with non-specific chronic low back pain-based ultrasonographic evaluation","volume":"13","author":"Tamartash H","year":"2023","unstructured":"Tamartash H, Bahrpeyma F, Dizaji MM. The effect of transcutaneous electrical nerve stimulation on pain and electrical stimulation muscle thickness in patients with non-specific chronic low back pain-based ultrasonographic evaluation. Pain Manag. 2023;13(2):87\u201394."},{"key":"b16","series-title":"Int J Womens Health","first-page":"1","article-title":"Transcutaneous electrical nerve stimulation (TENS) for primary dysmenorrhea: an overview","volume":"12","author":"Elboim-Gabyzon M","year":"2020","unstructured":"Elboim-Gabyzon M, Kalichman L. Transcutaneous electrical nerve stimulation (TENS) for primary dysmenorrhea: an overview. Int J Womens Health. 2020;12:1\u201310."},{"key":"b17","series-title":"Clin Interv Aging","first-page":"1841","article-title":"Effects of transcutaneous electrical nerve stimulation (TENS) on acute postoperative pain intensity and mobility after hip fracture: a double-blinded, randomized trial","volume":"14","author":"Elboim-Gabyzon M","year":"2019","unstructured":"Elboim-Gabyzon M, Andrawus Najjar S, Shtarker H. Effects of transcutaneous electrical nerve stimulation (TENS) on acute postoperative pain intensity and mobility after hip fracture: a double-blinded, randomized trial. Clin Interv Aging. 2019;14:1841\u20131850."},{"issue":"8","key":"b18","series-title":"Am J Phys Med Rehabil","first-page":"652","article-title":"Analgesic effect of transcutaneous electrical nerve stimulation after laparoscopic cholecystectomy","volume":"91","author":"Silva MB","year":"2012","unstructured":"Silva MB, de Melo PR, de Oliveira NML, Crema E, Fernandes LFRM. Analgesic effect of transcutaneous electrical nerve stimulation after laparoscopic cholecystectomy. Am J Phys Med Rehabil. 2012;91(8):652\u2013657."},{"issue":"7","key":"b19","series-title":"J Pain","first-page":"623","article-title":"Hypoalgesic effect of the transcutaneous electrical nerve stimulation following inguinal herniorrhaphy: a randomized, controlled trial","volume":"9","author":"DeSantana JM","year":"2008","unstructured":"DeSantana JM, Santana-Filho VJ, Guerra DR, Sluka KA, Gurgel RQ, da Silva WM Jr. Hypoalgesic effect of the transcutaneous electrical nerve stimulation following inguinal herniorrhaphy: a randomized, controlled trial. J Pain. 2008;9(7):623\u2013629."},{"key":"b20","series-title":"BMJ","first-page":"n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page MJ","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM,  The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71."},{"issue":"1","key":"b21","series-title":"J Neurosurg Anesthesiol","first-page":"1","article-title":"Postoperative and preincisional electrical nerve stimulation TENS reduce postoperative opioid requirement after major spinal surgery","volume":"22","author":"Unterrainer AF","year":"2010","unstructured":"Unterrainer AF, Friedrich C, Krenn MH, Piotrowski WP, Golaszewski SM, Hitzl W. Postoperative and preincisional electrical nerve stimulation TENS reduce postoperative opioid requirement after major spinal surgery. J Neurosurg Anesthesiol. 2010;22(1):1\u20135."},{"issue":"4","key":"b22","series-title":"Turk Neurosurg","first-page":"618","article-title":"The effect of TENS on pain, function, depression, and analgesic consumption in the early postoperative period with spinal surgery patients","volume":"21","author":"Kara B","year":"2011","unstructured":"Kara B, Baskurt F, Acar S,  The effect of TENS on pain, function, depression, and analgesic consumption in the early postoperative period with spinal surgery patients. Turk Neurosurg. 2011;21(4):618\u2013624."},{"issue":"1","key":"b23","series-title":"Spine (Phila Pa 1976)","first-page":"109","article-title":"Transcutaneous electrical nerve stimulation for the relief of postoperative pain in children","volume":"13","author":"Carman D","year":"1988","unstructured":"Carman D, Roach JW. Transcutaneous electrical nerve stimulation for the relief of postoperative pain in children. Spine (Phila Pa 1976). 1988;13(1):109\u2013110."},{"issue":"10","key":"b24","series-title":"A clinical report. Phys Ther","first-page":"1517","article-title":"Transcutaneous electrical nerve stimulation for pain control after spinal fusion with Harrington rods","volume":"65","author":"Issenman J","year":"1985","unstructured":"Issenman J, Nolan MF, Rowley J, Hobby R. Transcutaneous electrical nerve stimulation for pain control after spinal fusion with Harrington rods. A clinical report. Phys Ther. 1985;65(10):1517\u20131520."},{"issue":"3","key":"b25","series-title":"Pain","first-page":"299","article-title":"Pain relief after low back surgery: the efficacy of transcutaneous electrical nerve stimulation","volume":"8","author":"Schuster GD","year":"1980","unstructured":"Schuster GD, Infante MC. Pain relief after low back surgery: the efficacy of transcutaneous electrical nerve stimulation. Pain. 1980;8(3):299\u2013302."},{"issue":"3","key":"b26","series-title":"Br J Anaesth","first-page":"308","article-title":"Transcutaneous electrical nerve stimulation in the management of acute postoperative pain","volume":"61","author":"McCallum MI","year":"1988","unstructured":"McCallum MI, Glynn CJ, Moore RA, Lammer P, Phillips AM. Transcutaneous electrical nerve stimulation in the management of acute postoperative pain. Br J Anaesth. 1988;61(3):308\u2013312."},{"issue":"4","key":"b27","series-title":"Psychol Med","first-page":"1007","article-title":"Clinical applications of visual analogue scales: a critical review","volume":"18","author":"McCormack HM","year":"1988","unstructured":"McCormack HM, Horne DJ, Sheather S. Clinical applications of visual analogue scales: a critical review. Psychol Med. 1988;18(4):1007\u20131019."},{"issue":"5","key":"b28","series-title":"Anesthesiology","first-page":"1232","article-title":"Effect of the frequency of transcutaneous electrical nerve stimulation on the postoperative opioid analgesic requirement and recovery profile","volume":"91","author":"Hamza MA","year":"1999","unstructured":"Hamza MA, White PF, Ahmed HE, Ghoname EA. Effect of the frequency of transcutaneous electrical nerve stimulation on the postoperative opioid analgesic requirement and recovery profile. Anesthesiology. 1999;91(5):1232\u20131238."},{"issue":"5","key":"b29","series-title":"Anesth Analg","first-page":"1129","article-title":"The effect of location of transcutaneous electrical nerve stimulation on postoperative opioid analgesic requirement: acupoint versus nonacupoint stimulation","volume":"87","author":"Chen L","year":"1998","unstructured":"Chen L, Tang J, White PF,  The effect of location of transcutaneous electrical nerve stimulation on postoperative opioid analgesic requirement: acupoint versus nonacupoint stimulation. Anesth Analg. 1998;87(5):1129\u20131134."},{"issue":"6","key":"b30","series-title":"Middle East J Anaesthesiol","first-page":"815","article-title":"TENS compared to opioids in postoperative analgesic therapy after major spinal surgery with regard to cognitive function","volume":"21","author":"Unterrainer AF","year":"2012","unstructured":"Unterrainer AF, Uebleis FX, Gross FA, Werner GG, Krombholz MA, Hitzl W. TENS compared to opioids in postoperative analgesic therapy after major spinal surgery with regard to cognitive function. Middle East J Anaesthesiol. 2012;21(6):815\u2013821."},{"issue":"12","key":"b31","series-title":"World J Surg","first-page":"1563","article-title":"Prospective, randomized, placebo-controlled study of the effect of TENS on postthoracotomy pain and pulmonary function","volume":"29","author":"Erdogan M","year":"2005","unstructured":"Erdogan M, Erdogan A, Erbil N, Karakaya HK, Demircan A. Prospective, randomized, placebo-controlled study of the effect of TENS on postthoracotomy pain and pulmonary function. World J Surg. 2005;29(12):1563\u20131570."},{"issue":"1","key":"b32","series-title":"J Cardiothorac Surg","first-page":"186","article-title":"The effects of cold compress and transcutaneous electrical nerve stimulation on the pain associated with chest tube removal among patients with coronary bypass grafting","volume":"18","author":"Hatefi F","year":"2023","unstructured":"Hatefi F, Kazemi M, Manglian P, Shahi Moridi D, Heydari S, Hasani H. The effects of cold compress and transcutaneous electrical nerve stimulation on the pain associated with chest tube removal among patients with coronary bypass grafting. J Cardiothorac Surg. 2023;18(1):186."},{"issue":"1","key":"b33","series-title":"Clin J Pain","first-page":"12","article-title":"High and low frequency TENS reduce postoperative pain intensity after laparoscopic tubal ligation: a randomized controlled trial","volume":"25","author":"Desantana JM","year":"2009","unstructured":"Desantana JM, Sluka KA, Lauretti GR. High and low frequency TENS reduce postoperative pain intensity after laparoscopic tubal ligation: a randomized controlled trial. Clin J Pain. 2009;25(1):12\u201319."},{"issue":"8","key":"b34","series-title":"Minerva Anestesiol","first-page":"887","article-title":"Transcutaneous electrical nerve stimulation on acupoints reduces fentanyl requirement for postoperative pain relief after total hip arthroplasty in elderly patients","volume":"78","author":"Lan F","year":"2012","unstructured":"Lan F, Ma YH, Xue JX, Wang TL, Ma DQ. Transcutaneous electrical nerve stimulation on acupoints reduces fentanyl requirement for postoperative pain relief after total hip arthroplasty in elderly patients. Minerva Anestesiol. 2012;78(8):887\u2013895."},{"issue":"3","key":"b35","series-title":"JAMA Surg","first-page":"292","article-title":"Enhanced recovery after surgery: a review","volume":"152","author":"Ljungqvist O","year":"2017","unstructured":"Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: a review. JAMA Surg. 2017;152(3):292\u2013298."},{"issue":"3","key":"b36","series-title":"Am J Surg","first-page":"530","article-title":"Enhanced recovery after surgery: a clinical review of implementation across multiple surgical subspecialties","volume":"219","author":"Smith TW Jr","year":"2020","unstructured":"Smith TW Jr, Wang X, Singer MA, Godellas CV, Vaince FT. Enhanced recovery after surgery: a clinical review of implementation across multiple surgical subspecialties. Am J Surg. 2020;219(3):530\u2013534."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/41\/1\/article-p97.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/41\/1\/article-p97.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/41\/1\/article-p97.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:19:04Z","timestamp":1733491144000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/41\/1\/article-p97.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,1]]},"references-count":36,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2024.1.spine231079","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2024,7,1]]}}}