Longitudinal Study to Better Understand Neuropathic Back Pain as a Means of Improving Patient Selection for 10 kHz Spinal Cord Stimulation

Abstract

AbstractObjectiveTo create a questionnaire that can identify patients who will respond well to high-frequency spinal cord stimulation.Materials and MethodsThirty-three patients who received permanent implantation of a high-frequency spinal cord stimulator were followed for up to one year. Preoperative patient data in the form of a packet containing pain metrics, the Douleur Neuropathique 4 (DN4) questionnaire, and a questionnaire thought to contain clinically useful questions were collected. Visual analog scale (VAS), Oswestry Disability Index (ODI), and subjective overall percent pain reduction were collected at time points of 6 weeks, 3 months, 6 months, and 12 months.ResultsPatients who revealed that they could walk before a long period of time before their pain worsened, whose pain was consistent throughout the day, whose pain wakes them up from sleep and whose pain is worse when leaning side to side had a significant increase in ODI following SCS. Additionally, patients who reported only being able to sit or lie down for less than thirty minutes before having to move experienced significantly decreased ODI.ConclusionsWhile literature has shown that patients with neuropathic pain respond to SCS, identifying which patients clinically would have an optimal response remains a challenge. Future studies on a greater number of patients are needed to further develop a questionnaire to better identify clinical signs consistent with low back pain that will respond to spinal cord stimulation.Statements and DeclarationsSources of Financial SupportFinancial support for this project was provided by NevroConflict of InterestsDr. Ashwini Sharan reports personal fees from Neuspera, personal fees from Medtronic, grants and personal fees from Dixi, personal fees and other from Cerebral Therapeutics, outside the submitted work. Dr. Chengyuan Wu reports grants from Nevro, during the conduct of the study; personal fees from Nevro, personal fees from Abbott, personal fees from Medtronic, personal fees from Boston Scientific, personal fees from MicroSystems Engineering, outside the submitted work.