Sustainability of Pain Reduction from Trial Stimulation to Long-Term Follow-Up in Chronic Pain Patients with Spinal Cord Stimulation: A Retrospective Analysis

Background/Objectives: Before permanent implantation of a Spinal Cord Stimulation (SCS) system for treatment of chronic pain conditions a trial phase is standard, though its utility is increasingly disputed. Comparisons of long-term to trial-phase pain levels are sparse, and whether trial pain scores predict system explantation risk is unclear. We compare long-term and trial-phase pain levels in SCS treatment and investigate association between trial numeric rating scale (NRS) pain score and explantation.

Methods

This retrospective, single-centre study analysed patients who underwent SCS implantation with long-term follow-up. Patients were included if baseline and trial NRS diaries were available and trial phase was successful. Missing follow-up NRS values were extracted from patient files, multiple imputation addressing remaining gaps. ROC analysis, log-rank test, logistic regression, and Cox proportional hazards models evaluated association between trial-phase NRS and explantation.