Is Spinal Cord Stimulation Still Effective After One or More Surgical Revisions?

Leplus, Aurélie; Voirin, Jimmy; Cuny, Emmanuel; Onno, Marie; Billot, Maxime; Rigoard, Philippe; Fontaine, Denys

doi:10.1016/j.neurom.2023.03.009

Cited by 6 publications

(1 citation statement)

References 16 publications

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“…The "sustain" subgroup of patients, although limited in size (n = 7), maintained the efficacy of SCS with their new device for up to 1.3 years after conversion. Previous studies had reported that SCS efficacy can be sustained over time after replacing the IPG, and that pain relief after replacement did not differ when compared to de novo implants [49,50].…”

Section: Discussionmentioning

confidence: 81%

Improved Outcomes and Therapy Longevity after Salvage Using a Novel Spinal Cord Stimulation System for Chronic Pain: Multicenter, Observational, European Case Series

Rigoard,

Billot,

Bougeard

et al. 2024

JCM

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Spinal cord stimulation (SCS) is proven to effectively relieve chronic neuropathic pain. However, some implanted patients may face loss of efficacy (LoE) over time, and conversion to more recent devices may rescue SCS therapy. Recent SCS systems offer novel stimulation capabilities, such as temporal modulation and spatial neural targeting, and can be used to replace previous neurostimulators without changing existing leads. Our multicenter, observational, consecutive case series investigated real-world clinical outcomes in previously implanted SCS patients who were converted to a new implantable pulse generator. Data from 58 patients in seven European centers were analyzed (total follow-up 7.0 years, including 1.4 years after conversion). In the Rescue (LoE) subgroup (n = 51), the responder rate was 58.5% at the last follow-up, and overall pain scores (numerical rating scale) had decreased from 7.3 ± 1.7 with the previous SCS system to 3.5 ± 2.5 (p < 0.0001). Patients who converted for improved battery longevity (n = 7) had their pain scores sustained below 3/10 with their new neurostimulator. Waveform preferences were diverse and patient dependent (34.4% standard rate; 44.8% sub-perception modalities; 20.7% combination therapy). Our results suggest that patients who experience LoE over time may benefit from upgrading to a more versatile SCS system.

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Section: Discussionmentioning

confidence: 81%