BETHESDA, MD — Spinal cord stimulator (SCS) implantation has shown some effectiveness for chronic pain, including painful musculoskeletal disorders (MSDs).
A study in the Journal of Pain Research examined the characteristics and outcomes of veterans receiving SCSs in VHA facilities.
National Institutes of Health and Walter Reed National Military Medical Center -led researchers drew samples from 815,475 patients in the MSD Cohort, limiting the group to three MSDs with the highest number of implants.
Included in the study were 1,490 veterans with musculoskeletal injuries who received SCS implants from 2000 to 2012. Most, 95%, of them had pain intensity numeric rating scale data both pre- and post-implant, according to the authors.
Results indicate that higher pain NRS ratings were found in veterans who were 35-44 years old, white, and married. Patients with comorbid inclusion diagnoses, no medical comorbidities, a BMI 25-29.9, or with history of depressive disorder diagnosis were more likely to receive SCS, while those 55 and older or with an alcohol or substance use disorder were less likely to get the procedure. The study noted that more than 90% of those receiving an SCS were prescribed opioids in the year prior to implant.
Researchers reported that veterans who had a presurgical pain score of 4 or greater had a clinically meaningful decrease in their pain score in the year following their 90-day recovery period (Day 91-456) greater than expected by chance alone.
At the same time, the study added, the percent of veterans receiving opioid therapy significantly decreased (92.4% vs 86.6%, p<0.0001) as did the average opioid dose [morphine equivalent dose per day (MEDD) =26.48 vs MEDD=22.59, p<0.0003].
“Results offer evidence of benefit for some veterans with the examined conditions. Given known risks of opioid therapy, the reduction is an important potential benefit of SCS implants,” the authors wrote.
- Wandner LD, Fenton BT, Goulet JL, Carroll CM, Heapy A, Higgins DM, Bair MJ, Sandbrink F, Kerns RD. Treatment of a Large Cohort of Veterans Experiencing Musculoskeletal Disorders with Spinal Cord Stimulation in the Veterans Health Administration: Veteran Characteristics and Outcomes. J Pain Res. 2020 Jul 7;13:1687-1697. doi: 10.2147/JPR.S241567. PMID: 32753944; PMCID: PMC7354010.