A prospective study of BurstDR™ spinal cord stimulation for non-operated discogenic low back pain

Martijn R Mons; Kenneth B Chapman; Chris Terwiel; Elbert A Joosten; Jan-Willem Kallewaard

doi:10.1111/papr.13181

A prospective study of BurstDR™ spinal cord stimulation for non-operated discogenic low back pain

Pain Pract. 2023 Mar;23(3):234-241. doi: 10.1111/papr.13181. Epub 2022 Nov 23.

Authors

Martijn R Mons^{1

2}, Kenneth B Chapman^{3

4}, Chris Terwiel⁵, Elbert A Joosten^{1

2}, Jan-Willem Kallewaard^{5

6}

Affiliations

¹ Department of Anesthesiology and Pain Management, University Pain Clinic Maastricht (UPCM) Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands.
² Department of Translational Neuroscience, School for Mental Health and Neuroscience (MHeNS), University of Maastricht, Maastricht, The Netherlands.
³ Department of Anesthesiology, New York University Langone Medical Center, New York City, New York, USA.
⁴ Departement of Anesthesiology, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.
⁵ Department of Anesthesiology and Pain Management Arnhem, Rijnstate Hospital, Arnhem, The Netherlands.
⁶ Department of Anesthesiology and Pain Managmenent, Amsterdam University Medical Center, Amsterdam, The Netherlands.

PMID: 36373868
DOI: 10.1111/papr.13181

Abstract

Introduction: Chronic discogenic low back pain (CD-LBP) is caused by degeneration of the disc due to trauma to the annulus or by unprovoked degeneration, resulting in chronic pain. Spinal cord stimulation (SCS) employing the BurstDR™ waveform has been shown to be an effective treatment in a variety of chronic pain conditions. The aim of this prospective case study was to determine the effect of BurstDR™ SCS on pain relief, disability, and patient satisfaction in a population with CD-LBP.

Methods: Seventeen subjects with CD-LBP received a SCS trial with BurstDR™ stimulation. Patients with >50% pain relief after a trial period of 2 weeks were permanently implanted (n = 15). Patients then rated LBP and leg pain using the numeric rating scale (NRS), Oswestry disability index (ODI), patient global impression of change (PGIC), EQ-5D quality of life, and painDETECT for neuropathic pain at baseline following trial, 3, 6, and 12 months after permanent implantation.

Results: Treatment with BurstDR™ SCS resulted in significant reduction of LBP as the NRS was reduced from 71.7 ± 7.3 at baseline to 42.5 ± 18.1 at 12 months. Average pain relief at 12 months was 42.5%. In patients with leg pain (n = 8), pain was significantly reduced from 66.9 ± 8.2 to 11.7 ± 10.4 at 12 months. PainDETECT scores for neuropathic pain significantly reduced from 18.9 ± 4.8 at baseline, and 14.8 ± 3.2 at 12 months. Baseline ODI score significantly reduced from 41.2 ± 12.8 to 25.8 ± 8.6 at 12 months. PGIC scores remained low from 2.6 ± 1.6 at 3 months, 2.5 ± 1.0 at 6 months, and 2.5 ± 1.3 at 12 months. EQ-5D-5L rates remained constant from baseline 56.10 ± 23.9 to 68.6 ± 12.9 at 12 months.

Conclusion: BurstDR™ SCS resulted in significant reduction of back pain, leg pain, and quality of life in patients with CD-LBP and decreased the level of disability and generated positive patient satisfaction scores.

Trial registration: ClinicalTrials.gov NCT03958604.

Keywords: burst stimulation; discogenic low back pain; spinal cord stimulation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Chronic Pain* / therapy
Humans
Low Back Pain* / therapy
Neuralgia* / therapy
Pain Measurement / methods
Prospective Studies
Quality of Life
Spinal Cord
Spinal Cord Stimulation* / methods
Treatment Outcome

Associated data

ClinicalTrials.gov/NCT03958604