Spinal cord stimulation trumps medication for pain reduction — 7 takeaways


Researchers discovered patients with intractable spine or limb pain have less pain when treated with spinal cord stimulation compared to medication, according to Medscape.

Here are seven takeaways from the research, which was presented at the American Academy of Pain Medicine 2018 Annual Meeting, April 25 to 29 in Vancouver, Canada.

1. The study involved 12 randomized controlled trials.

The most common condition in the 1,080 study patients was back and/or leg pain in the location of previous spine procedures followed by complex regional pain syndrome. Two trials exclusively included patients with painful diabetic neuropathy.

2. In most of the trials, medical therapy consisted of medications such as gabapentin, tricyclic antidepressants and opioids.

3. Using a random-effect meta-analysis and frequentist indirect comparison methods to compare the interventions, researchers found:

  • In three trials, spinal stimulation increased the chances of pain relief by at least 50 percent compared with medical therapy.
  • In three trials, stimulation significantly reduced pain compared with medical therapy.
  • Compared with conventional stimulation, newer technology stimulation increased the likelihood of pain reduction.

4. "Opioids don't work very well for patients with nerve-related pain and yet many patients are treated with these drugs. On the other hand, spinal cord stimulation has been shown to work quite well for many types of neuropathic pain," author Tim Lamer, MD, told Medscape.

Dr. Lamar is an anesthesiology professor at Rochester, Minn.-based Mayo Clinic College of Medicine and Science and the American Academy of Pain Medicine president-elect.

5. The researchers also compared newer spinal cord stimulation with medical therapy, but they haven't reported those results yet.

6. Head-to-head efficacy trials are needed to determine whether physicians should use newer techniques of neuromodulation or traditional spinal cord stimulation, according to pain specialist James Watson, MD.

Dr. Watson is an associate professor and vice chair of the neurology department at the Mayo Clinic.

7. The study was supported by a grant from Medtronic.

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