Sensor driven-position adaptive versus conventional spinal cord stimulation in failed back surgery syndrome: a retrospective case series

Abstract

Background: Failed back surgery syndrome (FBSS) is a common problem affecting 20-40% of cases undergoing spine surgeries. Spinal cord stimulation (SCS) has been shown to be an efficient and relatively safe treatment in managing many intractable chronic pain syndromes.Objectives: This study compares the efficacy and safety of MR-compatible sensor driven-position adaptive SCS and conventional SCS in treating FBSS. Methods: This is a retrospective case series of 120 consecutive FBSS patients who underwent SCS between February 2011 and March 2018. Pain levels, analgesic/opioid use, and sleep problems were assessed before and 3 months after the procedure in patients who received either conventional SCS (group 1; n = 62) or sensor-driven position adaptive SCS (group 2; n = 34). The degree of patient satisfaction, the change in the activities of daily living (ADLs) together with the rate of complications were compared in both treatment groups. Results: The two treatment groups were homogenous at baseline. Patients in both groups improved significantly regarding pain, opioid consumption, sleep, and ADLs. The magnitude of improvement was statistically higher in group 2. An absolute reduction of 6 points on the VAS in patients who received position adaptive SCS vs a 3.3 point reduction in conventional SCS cases (p < 0.0001). Half of the patients in group 2 (n = 17) showed excellent satisfaction after the procedure versus 14.5% of cases in group 1 (n = 9). Conclusion: SCS is an efficient and reliable treatment in FBSS. MR-compatible sensor driven-position adaptive SCS can be a more effective treatment in this patient group.

A New Direction for Closed-Loop Spinal Cord Stimulation: Combining Contemporary Therapy Paradigms with Evoked Compound Action Potential Sensing

“…With posture-responsive stimulation, subjects manually adjusted their stimulation an average of 18.2 times per day in addition to the automatic adjustments, which was 41% fewer button-presses than when using conventional SCS. 9 Similarly, better pain relief and higher satisfaction for posture-responsive stimulation compared to conventional SCS have been reported in large retrospective comparative trials after 3 months (n=96) 36 and 24 months (n=187). 37 …”

Machine Learning in Spinal Cord Stimulation for Chronic Pain

“…[28][29][30][31] Positional changes in the body have proven to be an effective input to improve pain relief in SCS patients. [32][33][34][35] More recently, evoked compound action potentials (ECAPs) have demonstrated efficacy as inputs for adaptive SCS. 27,[36][37][38] Pertinently, both these inputs have demonstrated the capacity to be processed by MLbased classifiers.…”