EPV023 - DRG STIMULATION IS AN EFFECTIVE SALVAGE THERAPY FOR IMPROVING PAIN AND PSYCHOLOGICAL OUTCOMES IN PATIENTS WHO FAILED DORSAL COLUMN STIMULATION: PROLONG SUB-ANALYSIS (ID 505)
- Corey Hunter, United States of America
- Corey Hunter, United States of America
- Julie Pilitsis, United States of America
- Steven Falowski, United States of America
- Jason E. Pope, United States of America
- Misagh Mansouri, United States of America
- Timothy R. Deer, United States of America
Abstract
Introduction
Spinal cord stimulation (SCS) has been shown to effectively relieve chronic intractable pain. However, a portion of patients who initially succeed with SCS having waning therapeutic benefits over time. Stimulation of the dorsal root ganglion (DRG) has been found to provide more effective treatment of complex regional pain syndrome and peripheral causalgia than SCS. PROLONG (NCT039088476) is a multi-center, open-label, post-market study. The study prospectively observes subjects who switch to burst capable devices or DRG stimulation after loss of pain relief with their previous SCS system. Herein we report on subjects who received DRG stimulation. We present 6-month (6M) follow-up results for a range of patient-reported outcomes.
Methods/Materials
Eligible subjects had a pain score of ≥ 6 on the Numerical Rating Scale (NRS), had a functioning SCS system implanted, and did not report pain outside of the original treatment area. Patient-reported outcomes presented here include NRS, PROMIS-29 physical function, the Pain Catastrophizing Scale (PCS), and Pain Vigilance and Awareness Questionnaire (PVAQ). These measures can identify improvements accounting for an individual’s perspective of their pain experience.
Results
Fifteen subjects (57% female), with waning or loss of therapeutic benefits with SCS, received DRG implants. Most subjects are of working age (median age=57, 10 subjects below 65). We present data from 13 subjects who have completed the 6M follow-up visits. The NRS score improved from 7.5 ± 1.6 at baseline to 4.1 ± 3.0 at 6M. 69% (9/13) of subjects showed at least a two-point reduction in NRS score at 6M. 62% (8/13) showed a reduction of 30% or higher in NRS at 6M. The average PCS score improved from 25.8 ± 15.6 at baseline to 13.7 ± 18.2 at 6M. Fifty percent (3/6) of subjects clinically catastrophizing at baseline (≥ 30) reported improvement of symptoms at 6M follow-up (< 30). 62% (8/13) of subjects with severe or moderate pain interference (≥ 60) at baseline reduced symptoms by at least one category at 6M. Pain vigilance also improved from 15.4 ± 9.1 (n=15) at baseline to 12.5 ± 9.0 (n=13) at 6M.
Discussion
DRG stimulation can reduce pain in a patient population reporting failure of other SCS therapies. In addition, this small cohort of 6-month data supports the effectiveness of DRG stimulation in improving pain-related emotional well-being in patients with chronic intractable pain.
Conclusions
DRG stimulation is an effective salvage therapy for improving pain and psychological outcomes in patients who failed dorsal column stimulation.
