Peripheral Nerve Field Stimulation for Chronic Back Pain: Therapy Outcome Predictive Factors

While Spinal Cord Stimulation (SCS) provides satisfaction to almost 2/3 of Persistent Spinal Pain Syndrome-Type 2 (PSPS-T2) patients implanted for refractory chronic back and/or leg pain when not adequately addressed the back pain component, leaves patients in a therapeutic cul-de-sac. Peripheral Nerve field Stimulation (PNfS) has shown interesting results addressing back pain in the same population. Far from placing these two techniques in opposition, we suggest that these approaches could be combined to better treat PSPS-T2 patients. We designed a RCT (CUMPNS), with a 12-month follow-up, to assess the potential added value of PNfS, as a salvage therapy, in PSPS-T2 patients experiencing a “Failed SCS Syndrome” in the back pain component. Fourteen patients were included in this study and randomized into 2 groups (“SCS + PNfS” group/n=6 vs “SCS only” group/n=8). The primary objective of the study was to compare the percentage of back pain surface decrease after 3 months, using a computerized interface to obtain quantitative pain mappings, combined with multi-dimensional SCS outcomes. Back pain surface decreased significantly greater for the ”SCS+PNfS” group (80.2% ± 21.3%) compared to the “SCS only” group (13.2% ± 94.8%) (p=0.012), highlighting the clinical interest of SCS+PNfS, in cases where SCS fails to address back pain.

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Peripheral Nerve Field Stimulation for the Management of Localized Chronic Intractable Back Pain: Results From a Randomized Controlled Study

Neuromodulation Technology at the Neural Interface ◽

10.1111/ner.12055 ◽

2013 ◽

Vol 16 (6) ◽

pp. 565-575 ◽

Cited By ~ 40

Author(s):

W. Porter McRoberts ◽

Richard Wolkowitz ◽

D Joseph Meyer ◽

Eugene Lipov ◽

Jay Joshi ◽

...

Keyword(s):

Back Pain ◽

Peripheral Nerve ◽

Randomized Controlled Study ◽

Controlled Study ◽

Field Stimulation ◽

Randomized Controlled ◽

Peripheral Nerve Field Stimulation

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The Added Value of Subcutaneous Peripheral Nerve Field Stimulation Combined with SCS, as Salvage Therapy, for Refractory Low Back Pain Component in Persistent Spinal Pain Syndrome Implanted Patients: A Randomized Controlled Study (CUMPNS Study) Based on 3D-Mapping Composite Pain Assessment

Journal of Clinical Medicine ◽

10.3390/jcm10215094 ◽

2021 ◽

Vol 10 (21) ◽

pp. 5094

Author(s):

Philippe Rigoard ◽

Amine Ounajim ◽

Lisa Goudman ◽

Benedicte Bouche ◽

Manuel Roulaud ◽

...

Keyword(s):

Back Pain ◽

Peripheral Nerve ◽

Salvage Therapy ◽

Pain Syndrome ◽

Spinal Pain ◽

Added Value ◽

Controlled Study ◽

Field Stimulation ◽

Peripheral Nerve Field Stimulation ◽

Spinal Pain Syndrome

While Spinal Cord Stimulation (SCS) provides satisfaction to almost 2/3 of Persistent Spinal Pain Syndrome-Type 2 (PSPS-T2) patients implanted for refractory chronic back and/or leg pain, when not adequately addressed the back pain component, leaves patients in a therapeutic cul-de-sac. Peripheral Nerve field Stimulation (PNfS) has shown interesting results addressing back pain in the same population. Far from placing these two techniques in opposition, we suggest that these approaches could be combined to better treat PSPS-T2 patients. We designed a RCT (CUMPNS), with a 12-month follow-up, to assess the potential added value of PNfS, as a salvage therapy, in PSPS-T2 patients experiencing a “Failed SCS Syndrome” in the back pain component. Fourteen patients were included in this study and randomized into 2 groups (“SCS + PNfS” group/n = 6 vs. “SCS only” group/n = 8). The primary objective of the study was to compare the percentage of back pain surface decrease after 3 months, using a computerized interface to obtain quantitative pain mappings, combined with multi-dimensional SCS outcomes. Back pain surface decreased significantly greater for the ”SCS + PNfS” group (80.2% ± 21.3%) compared to the “SCS only” group (13.2% ± 94.8%) (p = 0.012), highlighting the clinical interest of SCS + PNfS, in cases where SCS fails to address back pain.

Download Full-text