PRESENTATION #6 Clinical Research | Pain Medicine
COMPARISON OF SPINAL CORD STIMULATOR EFFICACY AND EXPLANT RATES IN MULTIPLE OUTPATIENT CLINICS
Carmel Alemayehu, BS, Maged Guirguis, MD, Gassan Chaiban, MD, Reena John, MD, Manjunath Shetty, MD, Darby Larson, BS, Yashar Eshraghi, MD
Ochsner Health System
Presenter: Carmel Alemayehu, BS
Ochsner Health System
Historically, methods of treatment for chronic pain have included high daily doses of opioid medications or more invasive procedures; the former can lead to high rates of addiction or overdose, while the latter are non-reversible and not guaranteed to work. Spinal cord stimulators were developed as a minimally invasive and long-term pain treatment for various chronic pain syndromes. Unfortunately, recent research on long-term outcomes of SCSs are focused on high explant rate of the devices. Common reasons for explant include: infection, hematomas, pain at device site status post implantation, weight loss, or ineffectiveness. Although SCS manufacturers produce clinically useful devices, there is no data comparing manufacturers directly to reveal which devices have higher explant rates and why.
We are using survey questionnaires and retrospective chart reviews in order to evaluate effectiveness and explant rates of SCS devices from different manufacturers, as well as identifying pertinent patient and patient pain characteristics to develop a predictive formula for SCS success or explant. Patient records will be used to collect data on diagnoses related to SCS implant, trial/implant success or failure, history of any prior devices, levels of pain relief, and demographics.
Preliminary analysis of 141 patient surveys include 27.7% dissatisfaction rate, 11.2% explant rate, and 12.6% SCS not actively in use though still implanted. With additional data and retrospective chart reviews, we will find trends in dissatisfaction and explant by manufacturer, and identify patient cohorts who respond best to this mode of pain relief.
An additional hope for this study is to expand and include a local registry of patient who receive a SCS. The registry will prompt patients to complete surveys, in order to gauge real-time pain relief and overall satisfaction for validation of our formula. This will serve as a basis for future research.