Use of a Psychological Evaluation Tool as a Predictor of Spinal Cord Stimulation Outcomes

Less Pain Relief, More Depression, and Female Sex Correlate With Spinal Cord Stimulation Explants

“…The role of physiologic and psychosocial variables leading to this difference in explant rate has yet to be elucidated. Previously we have found that patients with depression who were recommended for and completed a trial of antidepressants, psychotherapy, or both had greater improvement in PCS rumination ( p < 0.01), PCS helplessness ( p = 0.02), PCS total ( p = 0.02), and MPQ affective ( p < 0.01) than patients without depression or with depression that would not benefit from a trial of antidepressants or psychotherapy . When considered alongside our current findings, treatment for comorbid depression before SCS may considerably improve SCS outcomes.…”

Pain Catastrophizing Does Not Predict Spinal Cord Stimulation Outcomes: A Cohort Study of 259 Patients With Long-Term Follow-Up

“…However, at each follow-up visit, catastrophizing levels tracked correspondingly with pain intensity scores. This correlation between PCS scores and concomitantly measured pain intensity ratings has since been reproduced in multiple studies (28)(29)(30)(31)(32)(33)(34). It has been proposed, that rather than being used as a tool for predicting SCS treatment outcome, PCS scores should be considered an important supplementary outcome measure aiding in the evaluation of SCS treatment (35).…”

Risk Factors and Survival Analysis of Spinal Cord Stimulator Explantation

“…Furthermore, outcomes questionnaires that are available at the institutional level, such as Oswestry Disability Index, Visual Analog Scale, and SF-36, are absent from insurance claims data, which significantly limits the level of detail available to characterize patient outcomes. Another factor to consider for potential SCS candidates is preoperative psychological evaluations, which prior studies have shown to be an important predictor of postoperative outcomes; again, this unfortunately cannot be ascertained from insurance databases (22)(23)(24). Ultimately, although elective SCS explantation is suggestive of patient dissatisfaction and poor efficacy, we do not know this with certainty, nor do we know whether all patients who retain their devices are actively using them.…”