EPV067 - REAL WORLD EXPERIENCE USING A SCS-DEVICE WHICH PROVIDES INDIVIDUALIZED TREATMENT CUSTOMIZATION (ID 131)
- Georgios Matis, Germany
- Georgios Matis, Germany
- Veerle Visser-Vandewalle, Germany
Abstract
Introduction
The spinal cord stimulation (SCS) therapy is an evolving field. Nowadays we can customize simultaneously stimulation waveforms and field shapes. The scope of this work is to provide real world experience using a new system in treating chronic pain patients.
Methods/Materials
Forty five consecutive patients were treated with SCS and implanted with a new neurostimulator (IPG) (Precision Spectra WaveWriterTM, Boston Scientific Neuromodulation, Valencia, CA, USA). We collected baseline characteristics and reviewed the procedure information. The pain intensity was evaluated with the visual analogue scale (VAS).
Results
The mean age of the patients (21 males, 24 females) was 55 years. Thirty five patients had failed back surgery syndrome (FBSS), three complex regional pain syndrome (CRPS), three lumbar stenosis, and four other etiologies. Thirty two patients reported back and leg pain, seven only leg pain, and six other types of pain. The baseline VAS was 7.9, at the end of the trial 2.8 and after three months 2.9. Thirty eight patients had a SCS-system and 4 had a hybrid-system (SCS and PNFS). Twenty nine patients received a lead with 16 contacts. The tip of the lead was at T8 (48.6%), T9 (26.2%), and T10 (9%). The mean duration of the trial was 55.9 minutes. Thirty two patients preferred a polytherapy (tonic and 1kHz or tonic and Burst) and thirteen a monotherapy (Burst or 1kHz). We had one lead migration.
Discussion
It was possible to achieve a considerable pain relief even in patients where the coverage was not optimal. These results could be attributed to the combination therapy (layering more than one therapy at the same time), the subperception algorithms over multiple vertebral levels, and the waveform automation (automatic rotation through waveforms). Of note, the patients could enter real-time therapy ratings into their remote control which helped us identify which therapy provides the most relief with the lowest energy usage.
Conclusions
The goal of any advances in SCS-field should be to simplify personalization, achieve better outcomes and deliver the most effective therapy with the lowest energy usage.
References
Metzger et al.. Outcomes using a SCS device capable of simultaneous customization of stimulation waveform and field shape. Neuromodulation 2018;21:e41.
