Long-term Follow-up of Spinal Cord Stimulation with Percutaneous Leads:
A cross-sectional study in a single centre with 10-years experience.
DOI:
https://doi.org/10.25751/rspa.27615Keywords:
Chronic Pain, Spinal Cord Stimulation, Long-Term Effects, Treatment Outcome, ComplicationsAbstract
INTRODUCTION: Chronic pain continues to be a leading cause of disability and disease burden globally. Currently, spinal cord stimulation is approved for a variety of chronic pain syndromes, but there is insufficient long-term data regarding its effectiveness. Our goal is to evaluate the long-term outcome in patients treated with spinal cord stimulation with percutaneous leads.
METHODS: We retrospectively evaluated a cohort of patients who underwent a spinal cord system implantation with percutaneous leads between January 2011 and December 2020. The long-term outcome was measured by evaluating patient satisfaction using the global perceived effect scale, the explantation rate and the occurrence of complications. Potential effect modifiers were also assessed.
RESULTS: Forty-one patients underwent spinal cord stimulation system implantation. The mean (±SD) follow-up time was 5.5 years (±2.6 years). By the end of the follow-up, 26 patients (67%) reported feeling a substantial improvement and 9 (23%) reported feeling slightly better. Out of the 41 patients, 9 (22%) devices were explanted. The estimated mean time to device explantation was 8.4 years (95% confidence interval [CI] = 7.6–9.3). A total of 14 (34.1%) complications occurred in 13 patients. Hardware complications were more prevalent (71.4%), with lead migration being the most frequent (42.9%). We did not find predictors of treatment success.
CONCLUSION: Spinal cord stimulation with percutaneous leads is safe and might have long-term effect in carefully selected patients. Nevertheless, further research is needed in order to find predictors of treatment success.
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Copyright (c) 2023 Gerson Sebastião da Cruz, Ernesto Ruivo, Teresa Fontinhas, Lucindo Ormonde
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