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The Challenge of Converting “Failed Spinal Cord Stimulation Syndrome” Back to Clinical Success, Using SCS Reprogramming as Salvage Therapy, through Neurostimulation Adapters Combined with 3D-Computerized Pain Mapping Assessment: A Real Life Retrospective Study

While paresthesia-based Spinal Cord Stimulation (SCS) has been proven effective as treatment for chronic neuropathic pain, its initial benefits may lead to the development of “Failed SCS Syndrome’ (FSCSS) defined as decrease over time related to Loss of Efficacy (LoE) with or without Loss of Coverag...

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Autores principales: Rigoard, Philippe, Ounajim, Amine, Goudman, Lisa, Banor, Tania, Héroux, France, Roulaud, Manuel, Babin, Etienne, Bouche, Bénédicte, Page, Philippe, Lorgeoux, Bertille, Baron, Sandrine, Adjali, Nihel, Nivole, Kevin, Many, Mathilde, Charrier, Elodie, Rannou, Delphine, Poupin, Laure, Wood, Chantal, David, Romain, Moens, Maarten, Billot, Maxime
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8746025/
https://www.ncbi.nlm.nih.gov/pubmed/35012013
http://dx.doi.org/10.3390/jcm11010272
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author Rigoard, Philippe
Ounajim, Amine
Goudman, Lisa
Banor, Tania
Héroux, France
Roulaud, Manuel
Babin, Etienne
Bouche, Bénédicte
Page, Philippe
Lorgeoux, Bertille
Baron, Sandrine
Adjali, Nihel
Nivole, Kevin
Many, Mathilde
Charrier, Elodie
Rannou, Delphine
Poupin, Laure
Wood, Chantal
David, Romain
Moens, Maarten
Billot, Maxime
author_facet Rigoard, Philippe
Ounajim, Amine
Goudman, Lisa
Banor, Tania
Héroux, France
Roulaud, Manuel
Babin, Etienne
Bouche, Bénédicte
Page, Philippe
Lorgeoux, Bertille
Baron, Sandrine
Adjali, Nihel
Nivole, Kevin
Many, Mathilde
Charrier, Elodie
Rannou, Delphine
Poupin, Laure
Wood, Chantal
David, Romain
Moens, Maarten
Billot, Maxime
author_sort Rigoard, Philippe
collection PubMed
description While paresthesia-based Spinal Cord Stimulation (SCS) has been proven effective as treatment for chronic neuropathic pain, its initial benefits may lead to the development of “Failed SCS Syndrome’ (FSCSS) defined as decrease over time related to Loss of Efficacy (LoE) with or without Loss of Coverage (LoC). Development of technologies associating new paresthesia-free stimulation waveforms and implanted pulse generator adapters provide opportunities to manage patients with LoE. The main goal of our study was to investigate salvage procedures, through neurostimulation adapters, in patients already implanted with SCS and experiencing LoE. We retrospectively analyzed a cohort of patients who were offered new SCS programs/waveforms through an implanted adapter between 2018 and 2021. Patients were evaluated before and at 1-, 3-, 6- and 12-month follow-ups. Outcomes included pain intensity rating with a Visual Analog Scale (VAS), pain/coverage mappings and stimulation preferences. Last follow-up evaluations (N = 27) showed significant improvement in VAS (p = 0.0001), ODI (p = 0.021) and quality of life (p = 0.023). In the 11/27 patients with LoC, SCS efficacy on pain intensity (36.89%) was accompanied via paresthesia coverage recovery (55.57%) and pain surface decrease (47.01%). At 12-month follow-up, 81.3% preferred to keep tonic stimulation in their waveform portfolio. SCS conversion using adapters appears promising as a salvage solution, with an emphasis on paresthesia recapturing enabled via spatial retargeting. In light of these results, adapters could be integrated in SCS rescue algorithms or should be considered in SCS rescue.
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spelling pubmed-87460252022-01-11 The Challenge of Converting “Failed Spinal Cord Stimulation Syndrome” Back to Clinical Success, Using SCS Reprogramming as Salvage Therapy, through Neurostimulation Adapters Combined with 3D-Computerized Pain Mapping Assessment: A Real Life Retrospective Study Rigoard, Philippe Ounajim, Amine Goudman, Lisa Banor, Tania Héroux, France Roulaud, Manuel Babin, Etienne Bouche, Bénédicte Page, Philippe Lorgeoux, Bertille Baron, Sandrine Adjali, Nihel Nivole, Kevin Many, Mathilde Charrier, Elodie Rannou, Delphine Poupin, Laure Wood, Chantal David, Romain Moens, Maarten Billot, Maxime J Clin Med Article While paresthesia-based Spinal Cord Stimulation (SCS) has been proven effective as treatment for chronic neuropathic pain, its initial benefits may lead to the development of “Failed SCS Syndrome’ (FSCSS) defined as decrease over time related to Loss of Efficacy (LoE) with or without Loss of Coverage (LoC). Development of technologies associating new paresthesia-free stimulation waveforms and implanted pulse generator adapters provide opportunities to manage patients with LoE. The main goal of our study was to investigate salvage procedures, through neurostimulation adapters, in patients already implanted with SCS and experiencing LoE. We retrospectively analyzed a cohort of patients who were offered new SCS programs/waveforms through an implanted adapter between 2018 and 2021. Patients were evaluated before and at 1-, 3-, 6- and 12-month follow-ups. Outcomes included pain intensity rating with a Visual Analog Scale (VAS), pain/coverage mappings and stimulation preferences. Last follow-up evaluations (N = 27) showed significant improvement in VAS (p = 0.0001), ODI (p = 0.021) and quality of life (p = 0.023). In the 11/27 patients with LoC, SCS efficacy on pain intensity (36.89%) was accompanied via paresthesia coverage recovery (55.57%) and pain surface decrease (47.01%). At 12-month follow-up, 81.3% preferred to keep tonic stimulation in their waveform portfolio. SCS conversion using adapters appears promising as a salvage solution, with an emphasis on paresthesia recapturing enabled via spatial retargeting. In light of these results, adapters could be integrated in SCS rescue algorithms or should be considered in SCS rescue. MDPI 2022-01-05 /pmc/articles/PMC8746025/ /pubmed/35012013 http://dx.doi.org/10.3390/jcm11010272 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Rigoard, Philippe
Ounajim, Amine
Goudman, Lisa
Banor, Tania
Héroux, France
Roulaud, Manuel
Babin, Etienne
Bouche, Bénédicte
Page, Philippe
Lorgeoux, Bertille
Baron, Sandrine
Adjali, Nihel
Nivole, Kevin
Many, Mathilde
Charrier, Elodie
Rannou, Delphine
Poupin, Laure
Wood, Chantal
David, Romain
Moens, Maarten
Billot, Maxime
The Challenge of Converting “Failed Spinal Cord Stimulation Syndrome” Back to Clinical Success, Using SCS Reprogramming as Salvage Therapy, through Neurostimulation Adapters Combined with 3D-Computerized Pain Mapping Assessment: A Real Life Retrospective Study
title The Challenge of Converting “Failed Spinal Cord Stimulation Syndrome” Back to Clinical Success, Using SCS Reprogramming as Salvage Therapy, through Neurostimulation Adapters Combined with 3D-Computerized Pain Mapping Assessment: A Real Life Retrospective Study
title_full The Challenge of Converting “Failed Spinal Cord Stimulation Syndrome” Back to Clinical Success, Using SCS Reprogramming as Salvage Therapy, through Neurostimulation Adapters Combined with 3D-Computerized Pain Mapping Assessment: A Real Life Retrospective Study
title_fullStr The Challenge of Converting “Failed Spinal Cord Stimulation Syndrome” Back to Clinical Success, Using SCS Reprogramming as Salvage Therapy, through Neurostimulation Adapters Combined with 3D-Computerized Pain Mapping Assessment: A Real Life Retrospective Study
title_full_unstemmed The Challenge of Converting “Failed Spinal Cord Stimulation Syndrome” Back to Clinical Success, Using SCS Reprogramming as Salvage Therapy, through Neurostimulation Adapters Combined with 3D-Computerized Pain Mapping Assessment: A Real Life Retrospective Study
title_short The Challenge of Converting “Failed Spinal Cord Stimulation Syndrome” Back to Clinical Success, Using SCS Reprogramming as Salvage Therapy, through Neurostimulation Adapters Combined with 3D-Computerized Pain Mapping Assessment: A Real Life Retrospective Study
title_sort challenge of converting “failed spinal cord stimulation syndrome” back to clinical success, using scs reprogramming as salvage therapy, through neurostimulation adapters combined with 3d-computerized pain mapping assessment: a real life retrospective study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8746025/
https://www.ncbi.nlm.nih.gov/pubmed/35012013
http://dx.doi.org/10.3390/jcm11010272
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