Factors Contributing to Spinal Cord Stimulation Outcomes for Chronic Pain

Authors

Dakota T. Graham, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
Margaret Lambert, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
Zaman Mirzadeh, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
Francisco A. Ponce, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA. Electronic address: neuropub@barrowneuro.org.

Document Type

Article

Abstract

OBJECTIVE: Spinal cord stimulation (SCS) has been shown to be a safe and effective therapy for patients with chronic pain. However, some patients do not obtain or maintain adequate pain relief after SCS. The goal of this study was to identify factors that affect patient outcome with regard to SCS. MATERIALS AND METHODS: A retrospective analysis of electronic medical records at a single site was performed. Records for 181 patients who received SCS implants from 2014 through 2016 were collected with follow-up data captured up to August 2019. Patient outcome was measured by device explantation and patient benefit from the SCS. Study parameters included demographic characteristics, history of pain, SCS implant characteristics, and postimplantation events. RESULTS: An earlier diagnosis of radiculopathy was associated with an increased risk of poor benefit (relative risk [RR], 1.81; 95% CI, 1.19-2.74; p = 0.008). Postimplantation falls were associated with an increased risk of poor benefit (RR, 2.17; 95% CI, 1.48-3.17; p = 0.009). Device manufacturer was associated with both patient benefit and explantation. Device 2 was associated with a reduced risk of poor benefit (RR, 0.52; 95% CI, 0.32-0.85; p = 0.009). Device 4 was associated with an increased risk of poor benefit (RR, 1.71; 95% CI, 1.14-2.55; p = 0.02) and increased risk of device explantation (RR, 2.69; 95% CI, 1.2-6.02; p = 0.03). CONCLUSIONS: Patient outcome was associated with diagnosis, postimplantation falls, and device manufacturer. Further investigation is recommended to confirm associations through prospective studies that can more accurately quantify patient outcome over longer periods.

Keywords

Chronic pain, efficacy, explantation, neurostimulation, spinal cord stimulation

Medical Subject Headings

Chronic Pain (therapy); Humans; Pain Management; Prospective Studies; Retrospective Studies; Spinal Cord; Spinal Cord Stimulation; Treatment Outcome

Publication Date

1-1-2022

Publication Title

Neuromodulation : journal of the International Neuromodulation Society

E-ISSN

1525-1403

Volume

25

Issue

1

First Page

145

Last Page

154

PubMed ID

35041584

Digital Object Identifier (DOI)

10.1111/ner.13515

Recommended Citation

Graham, Dakota T.; Lambert, Margaret; Mirzadeh, Zaman; and Ponce, Francisco A., "Factors Contributing to Spinal Cord Stimulation Outcomes for Chronic Pain" (2022). Translational Neuroscience. 1235.
https://scholar.barrowneuro.org/neurobiology/1235