Objective, long-term mobility data in patients with chronic pain after lumbar spine surgery treated with spinal cord stimulation-a prospective, multicenter trial.

Abstract

Spinal cord stimulation (SCS) is a treatment option for chronic neuropathic pain conditions when conventional therapies have failed. However, objective and measurable long-term data on the effects of SCS are lacking. This study evaluates changes in objectively recorded mobility and the correlation with patient-reported outcomes in SCS-treated patients with intractable back and/or leg pain following lumbar spine surgery. Fifty patients were enrolled. Baseline mobility was recorded over 4 weeks using an external neurostimulator with a built-in accelerometer. Patients achieving ≥50% pain relief during a subsequent SCS test trial received a permanently implanted stimulator at the same site. Mobility data were extracted at 3, 6, and 12 months and compared with baseline alongside work status, medication usage, and patient-reported outcome measures. Thirty-seven patients received a permanent stimulator, and 32 completed the 12 month follow-up of activity data. Time spent in mobility episodes lasting at least 30 s was 34±27 min/24 hours for SCS-patients at baseline compared with 92±51 min for healthy controls (p=0.009). Mobility increased gradually after SCS, reaching statistical significance at 12 months (p=0.045). The increase was significant in patients with predominant leg pain (35±27 to 54±32 min, p=0.011) but not in those with predominant back pain. Significant improvements were observed in working ability, medication reduction, and self-reported outcomes. Increased mobility correlated significantly with reduction in self-reported disability (p=0.044) and leg pain (p=0.046). The new objective data indicate that SCS has beneficial, long-term effects on mobility in patients with intractable leg pain after spine surgery. NCT04710355.