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Clinical Science| Volume 26, ISSUE 3, P676-680, April 2023

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A Retrospective Comparison of Long-Term Treatment Results of Subcutaneous Stimulation and Spinal Cord Stimulation for Chronic Neuralgia

      Abstract

      Objectives

      Spinal cord stimulation (SCS) is known to be an effective long-term treatment option for chronic neuropathic pain. Subcutaneous stimulation (SubQ) is increasingly used to treat chronic back and neck pain, but long-term outcomes are unclear.

      Materials and Methods

      Patients with neurostimulation devices implanted during the past 16 years were evaluated. Their continuation or termination of the treatment was taken as a measure of long-term treatment success. Age, sex, underlying pain condition, stimulation modality (SCS, SubQ, or hybrid), occurrence, and reasons for treatment termination were documented. Patients were classified as long-term responders and long-term nonresponders and analyzed with their clinical data and stimulation modality. The sample consisted of 98 patients. Of these, 66 were treated with SCS, 21 with SubQ, and 11 with a hybrid system.

      Results

      Approximately 61.3% of patients receiving SubQ terminated the treatment within two years because of ineffectiveness, whereas only 28.8% of patients receiving SCS terminated their stimulation. Back and neck pain were associated with treatment termination (p = 0.011). SubQ was also significantly associated with treatment termination.

      Conclusions

      SubQ seems not to provide substantial long-term pain relief for back and neck pain because most patients abandoned their stimulation therapy.

      Keywords

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