Closed-Loop Spinal Cord Stimulation
Is greater pain reduction found with a closed-loop spinal cord stimulator (SCS) vs fixed-output, open-loop SCS system? Worldwise, 7.5% of people have low back pain, some including leg pain. JAMA Neurology reports findings from a study of participants with chronic, intractable back and leg pain for whom conservative therapy didn’t work. Over 130 patients were randomized to closed- or open-loop SCS. At 3 months, a year, and 2 years, superior pain relief was seen with the evoked compound action potentials-controlled, closed-loop SCS, which elicited a more consistent neural response. Improvements in such secondary outcomes as sleep, health-related quality of life, and physical and emotional functioning were also noted, along with opioid reduction or elimination.
The study showed no safety profiles differences between the 2 groups, and concluded, “ECAP-controlled SCS has demonstrated to provide a profoundly effective, reliable, and durable treatment option for patients with chronic pain, allowing for the potential of significant voluntary opioid reduction. Continued measurement of neurophysiological properties should lead to greater knowledge of underlying mechanism(s) of action and more efficacious therapy in the long term.”
Read the journal article.
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