Less Pain Relief, More Depression, and Female Sex Correlate With Spinal Cord Stimulation Explants. Issue 5 (19th August 2019)

• Record Type: Journal Article
• Authors: Slyer, Julia; Scott, Samae; Sheldon, Breanna; Hancu, Maria; Bridger, Cheyanne; Pilitsis, Julie G.
• Is Part Of: Neuromodulaton. Volume 23:Issue 5(2020)
• Page Start: 673
• Page End: 679
• Publication Date: 2019-08-19
• Subjects: Chronic pain -- explant rate -- explantation -- spinal cord stimulation; Central nervous system -- Physiology -- Periodicals; Central nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1111/ner.13036
• Languages: English
• ISSNs: 1094-7159

Abstract

Abstract : Background: Spinal cord stimulation (SCS) is a known therapy for a variety of chronic pain conditions, but over time a number of patients proceed to explants. Objectives: We compared explant rates based on degree of pain relief, diagnosis, lead location, gender, and age to determine possible predictors for SCS implant success. Methods: First, we performed a single‐center retrospective chart review of consecutive SCS‐implanted subjects was to document internal explant rates. Rates of explants based on diagnosis, gender, age, and lead location were compared to determine potential trends. We then examined which thoracic SCS patients in our prospectively collected outcome measures data base who were explanted. Results: A total of 63 of 671 thoracic SCS were explanted. Thoracic explants occurred in patients who were significantly younger ( p = 0.03). Women who were explanted reported significantly more discomfort from the device ( p = 0.05). When we looked at our data base of patients with a mean time implanted of 2.77 years and a minimum of one year follow‐up, 11 of 114 thoracic SCS patients were explanted. All explants were women. There was no correlation with diagnosis or age. Those who were explanted reported more pain ( p = 0.03) and depression ( p < 0.01) at one year follow‐up. Conclusions: Our data correlates explants with less pain relief and more depression. Women are more likely to have explants than men. The role of physiologic and psychosocial variables leading to this difference has yet to be elucidated.