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Papers of the Week

Papers: 5 Aug 2023 - 11 Aug 2023

Clinical, Resource

Human Studies, Medical Devices, Neurobiology, Neuromodulation

Musculoskeletal Pain

2023 Aug 02

J Pain


Real World Characterization of Chronic Pain, Success Rates and Implant Rates: Evidence from a Digital Health Platform of Patients Undergoing Spinal Cord Stimulation Evaluations.


Venkatraman V, Bharmi R, Coletti F, Gellad ZF, Lempel N, Amit R, Blank N, Brown J, Kumar C, Fishman M, Vallejo R, Datta D, Reeve BB, Chakravarthy K, Sharan AD, Lad SP


Spinal cord stimulation is an effective treatment for those experiencing chronic back and leg pain but requires a temporary evaluation period (SCSeval) before permanent implantation. We present real-world data from 7000 patients who underwent SCSeval while utilizing a mobile digital health platform for education, feedback, and outcomes collection during their surgical journey. We analyzed preoperative patient demographics, characterized patient pain profiles using the PROMIS-29 surveys, and calculated the rates of conversion from temporary to permanent SCS implantation. Between August 1, 2021 and March 2, 2023, 7000 patients (mean age 59.1, 59.6% female) underwent SCSeval procedures while utilizing a mobile application. Patients commonly experienced aching, sharp, stabbing, tingling, numb, and burning pain. Patients had tried multiple prior therapies and wanted to reduce their use of opioids and pain medications. Overall, 90.1% of patients had a successful SCSeval, and 80.4% of those converted to permanent implant, with the highest rates among those who underwent SCSeval in a hospital setting. There was significant improvement in all domains of pain as evaluated by pre-and-postoperative PROMIS-29 surveys. This study supports the use of digital health technology as part of the SCS journey to improve the patient experience and allow for robust patient reported outcomes collection. The overall rate of SCSeval to permanent SCS in our study of 72.4% was higher than national rates of 64%, suggesting that an app may allow clinicians to better quantify changes in chronic pain and provide more insight into choosing to implant SCS permanently. PERSPECTIVE: This article presents real world evidence from a digital health platform for therapy education and outcomes collection from patients undergoing spinal cord stimulation evaluation procedures. Such tools could allow for better pain characterization and allow for more nuanced tracking of patient outcomes among those with chronic pain.