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低能量差分靶点复用脊髓刺激衍生物在慢性背痛和/或腿痛患者中可在12个月内减轻疼痛并改善生活质量。

Low-energy differential target multiplexed SCS derivative reduces pain and improves quality of life through 12 months in patients with chronic back and/or leg pain.

作者信息

Peacock Jeffery, Provenzano David, Fishman Michael, Amirdelfan Kasra, Bromberg Todd, Schmidt Todd, White Thomas, Grewal Prabhdeep, Justiz Rafael, Calodney Aaron, El-Naggar Amr, Shah Binit, Esposito Michael, Gatzinsky Kliment, Kallewaard Jan Willem, Poree Lawrence, Cleland Andrew, Rice Calysta, Theis Erin, Noel Kate, LaRue Maddie

机构信息

Pain Management, Novant Health, Winston-Salem, North Carolina, USA.

Pain and Interventional Care, Pain Diagnostics and Interventional Care, Sewickley, Pennsylvania, USA.

出版信息

Pain Pract. 2025 Jan;25(1):e13407. doi: 10.1111/papr.13407. Epub 2024 Sep 11.

Abstract

INTRODUCTION

Energy-reducing spinal cord stimulation (SCS) approaches have the potential to impact patient experience with rechargeable and non-rechargeable SCS devices through reducing device recharge time or enhancing device longevity. This prospective, multi-center study evaluated the safety, effectiveness, and actual energy usage of differential target multiplexed (DTM) endurance therapy, a reduced energy DTM SCS derivative.

METHODS

Subjects who reported an overall pain visual analog score (VAS) of ≥6/10 cm and an Oswestry Disability Index score of 21-80 out of 100 at baseline with moderate to severe chronic, intractable back and/or leg pain were eligible. Evaluation visits occurred at 1, 3, 6, and 12 months post-device activation. The primary objective was to characterize change in overall pain intensity, as measured by VAS, from baseline to 3-month visit.

RESULTS

Fifty-seven subjects enrolled at 12 US sites from November 2020 through June 2021, 35 were implanted with a rechargeable SCS device, and 27 completed the 12-month visit. Subjects experienced a 50.4% mean reduction in overall pain from baseline at the 3-month follow-up that was sustained through 12 months. Additional outcomes including changes in overall, back, and leg pain intensity, quality of life, disability, therapy satisfaction, safety, and current battery usage are shown through 12-month follow-up.

CONCLUSION

The use of DTM endurance SCS therapy in this study resulted in reductions in pain relief through 12 months, demonstrating that energy-reducing stimulation patterns can provide clinical benefit. Clinically effective, reduced energy SCS derivatives have the potential to impact patient experience through either reduced recharge requirements or increased device longevity.

摘要

引言

节能型脊髓刺激(SCS)方法有可能通过减少设备充电时间或延长设备使用寿命来影响患者使用可充电和不可充电SCS设备的体验。这项前瞻性、多中心研究评估了差分目标多路复用(DTM)耐力疗法(一种能量降低的DTM SCS衍生物)的安全性、有效性和实际能量使用情况。

方法

入选标准为基线时总体疼痛视觉模拟评分(VAS)≥6/10 cm且Oswestry功能障碍指数评分为21 - 80(满分100),伴有中度至重度慢性顽固性背痛和/或腿痛的受试者。在设备激活后1、3、6和12个月进行评估访视。主要目标是描述从基线到3个月访视时,通过VAS测量的总体疼痛强度的变化。

结果

从2020年11月到2021年6月,在美国12个地点招募了57名受试者,35名植入了可充电SCS设备,27名完成了12个月的访视。在3个月随访时,受试者总体疼痛较基线平均降低了50.4%,并持续至12个月。通过12个月的随访还展示了包括总体、背部和腿部疼痛强度变化、生活质量、功能障碍、治疗满意度、安全性以及当前电池使用情况等其他结果。

结论

本研究中使用DTM耐力SCS疗法在12个月内实现了疼痛缓解,表明节能刺激模式可提供临床益处。临床有效的、能量降低的SCS衍生物有可能通过减少充电需求或延长设备使用寿命来影响患者体验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d582/11680466/982436a06aa2/PAPR-25-0-g007.jpg

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