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In oduc ion
Spinal co d s imula ion (SCS) is a p o en sa e and e ec i e
he apy ha can help o manage many ypes o ch onic in ac able
pain. SCS uses low ol age (elec ical) s imula ion o he spinal ne es
o help block he sensa ion o pain. To achie e SCS, a small ba e y-
powe ed gene a o is implan ed unde he skin o ansmi an elec ical
cu en o he spinal co d. The elec ical cu en gene a ed in e up s
pain signals being sen o he b ain and an indi idual being ea ed
gene ally eels pain elie . SCS is mos ly o e ed o pa ien s wi h
e ac o y ch onic back and leg pain (CBLP), nowadays e e ed o as
pe sis en spinal pain synd ome (PSPS). SCS he apy is i s o e ed
du ing a ial pe iod in which an SCS lead wi h elec odes, which is
placed o e he do sal column o he spinal co d, is connec ed o an
ex e nal neu os imula o h ough a pe cu aneous cable. S imula ion
pa ame e s a e hen selec ed o op imize pain con ol. In pa ien s
who espond o he he apy (>50% pain educ ion) an implan able
neu os imula o (INS) p o ides con inuous SCS- he apy. A e INS
implan , he pa ien e u ns o he pain clinic a egula in e als o
SCS- he apy check-ups and/o op imiza ion. I can ake weeks o
mon hs un il SCS- he apy is op imized, and pain supp ession has
eached a s able le el.
Se e al clinical s udies on SCS he apy o ea men o ch onic
pain ha e been pe o med o e decades.1–5 The e ec i eness o SCS
o ea men o PSPS has been shown in se e al obse a ional and
con olled s udies.5–9 In mos con olled SCS s udies he ocus has been
on clinical ou comes, such as pain, unc ionali y and pain medica ion
use and ha e been pe o med in selec ed pa ien popula ions.
Regis ies, on he o he hand, o en include pa ien s wi h di e en
pain e iologies and SCS de ices.10,11 Mos SCS de ices o e di e en
s imula ion wa e o ms, such as low-dose ( onic o con en ional) and
highe ene gy wa e o ms (e.g., Bu s , HF10, DTM). Se e al s udies
ha e demons a ed clinical e ec i eness o SCS wi h hese highe
ene gy s imula ion wa e o ms o ea men o PSPS in con olled
s udy se ings.12–17 Howe e , no much is known abou SCS use and he
p og ammed s imula ion pa ame e s in his pa ien popula ion in day-
o-day clinical use in specialized pain clinics. Some INS’s con ains an
accele ome e ha eco ds he o ien a ion o he implan ed de ice and
p o ide some me ics on he body posi ion o he use (e.g., up igh ,
ho izon al, ecline). Un il now, no s udies o egis ies ha e been
pe o med ha p o ide in o ma ion on he use o hese echnologies
in pain clinics whe e SCS is o e ed pe s anda d o ca e. The aim
o his pos -implan su ey is in ended o collec use expe iences,
and ou comes and de ice se ings om pa ien s who use spinal co d
s imula ion wi h a single neu os imula o model o ea men o
ch onic e ac o y back and leg pain.
In Phys Med Rehab J. 2025;10(1):20‒25. 20
©2025 Seoane e al. This is an open access a icle dis ibu ed unde he e ms o he C ea i e Commons A ibu ion License, which
pe mi s un es ic ed use, dis ibu ion, and build upon you wo k non-comme cially.
Objec i e se up desc ip ion and sa is ac ion
assessmen o spinal co d s imula ion o ea men
o ch onic back and leg pain
Volume 10 Issue 1 - 2025
1Fe ol Uni e si y Hospi al Complex, Fe ol, Spain
2Jiménez Díaz Founda ion Uni e si y Hospi al, Spain
3AZ Del a, Roesela e, Belgium
4B a is hospi al, Roosendaal, Ne he lands
5Vi gen Maca ena Uni e si y Hospi al, Se illa, Spain
6Cen al Uni e si y Hospi al o As u ias HUCA, O iedo, Spain
7Salamanca Uni e si y Hospi al, Salamanca, Spain
8VITAZ campus Sin -Niklaas Moe land, Belgium
9Pue a del Ma Uni e si y Hospi al, Cadiz, Spain
10Med onic, Inc., The Ne he lands
Co espondence: Rik Buschman PhD, Clinical Depa men ,
Med onic, Eindho en, The Ne he lands, Tel +31620910185
Recei ed: Ap il 11, 2025 | Published: Ap il 25, 2025
Abs ac
Objec i e: The aim o his su ey was o collec use (pa ien and heal h ca e p o essional)
sa is ac ion, he apy ou comes and de ice se ings om pa ien s who u ilize a single spinal
co d s imula ion model o ea men o ch onic pain in day- o-day clinical p ac ice.
Me hods: The design was a clinical su ey. The su ey popula ion we e pa ien s wi h
ch onic back and leg pain ecei ing spinal co d s imula ion he apy, and he heal h ca e
p o essionals who ea he pa ien s and p og am he implan able neu os imula o .
Pa ien da a we e collec ed once and a a ime when spinal co d s imula ion p o ided s able
pain elie . Da a was p esen ed in agg ega e o m. Nea 50 da a-i ems we e cap u ed pe
pa ien , including demog aphics (e.g., age, gende , p io su ge ies), echnical da a (e.g.,
implan de ails, s imula ion pa ame e s), pa ien epo ed ou comes (e.g., pain change,
goal achie emen , wo k) and sa is ac ion and heal h ca e p o essional sa is ac ion (e.g.,
sa is ac ion wi h neu os imula o size). Desc ip i e s a is ics we e used o summa ize he
da a. Con inuous a iables a e summa ized by compu ing mean and s anda d de ia ion.
Resul s: Clinical s a om nine Eu opean si es independen ly collec ed da a om 124
pa ien s. Pa ien s we e on a e age 54.3 (±11.2) yea s old and had ch onic pain o 9.9 (±6.0)
yea s. The a e age ime since spinal co d s imula ion onse was 2.6 yea s. The indica ion
o spinal co d s imula ion was o o e all pain (68.5%, 85/124), leg pain (22.6%, 28/124)
and back pain (8.9%, 11/124). On a e age, pa ien s epo ed an imp o emen in pain o
70.3% (± 17.1%) and pain medica ion was educed o 82.3% (102/124) o pa ien s. Thi y-
wo pa ien s (25.8%) e u ned o wo k o whom 16 (12.9%) e u ned o ull ime wo k.
Func ional goals measu ed on a VAS scale (0-100), we e p ede ined by 110 pa ien s, mos ly
o pain/medica ion educ ion, imp o ed quali y o li e, and mobili y. On a e age, he e was
an imp o emen in he p ede ined goal, o 73.3% (±17.0%).
Conclusions: The clinical su ey p o ided an o e iew o he use o spinal co d s imula ion
o a speci ic de ice and indica ion in a day- o-day clinical se ing.
In e na ional Physical Medicine & Rehabili a ion Jou nal
Resea ch A icle Open Access
Objec i e se up desc ip ion and sa is ac ion assessmen o spinal co d s imula ion o ea men o
ch onic back and leg pain 21
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©2025 Seoane e al.
Ci a ion: Seoane FJC, Ga cía JCLP, Fou SD,e al. Objec i e se up desc ip ion and sa is ac ion assessmen o spinal co d s imula ion o ea men o ch onic
back and leg pain. In Phys Med Rehab J . 2025;10(1):20‒25. DOI: 10.15406/ipm j.2025.10.00392
Me hods
Su ey design
The p ojec was designed as a c oss-sec ional, heal h esea ch
s udy in which clinical and p oduc - ela ed da a om many di e en
pa ien s we e collec ed by he ea ing medical s a a a single poin
in ime once SCS ea men had s abilized, and du ing ou ine pa ien
ollow-up. Addi ionally, he p ojec con ained ma ke esea ch on
expe iences and sa is ac ion o he ea ing heal hca e p o essional
wi h he SCS de ice (See below Da a Collec ion o de ails)
Neu os imula o
The INS in es iga ed in he su ey is he In ellis neu os imula o
(model 97715, Med onic). The de ice is small and echa geable,
has dedica ed ba e y echnology ha gua an ees as echa ging and
allows p og amming o di e en s imula ion modes, such as low-
ene gy ( onic, con en ional) and highe -ene gy modes. Fu he mo e,
he INS con ains an accele ome e ha eco ds he o ien a ion o he
de ice and wi h ha p o ides me ics on o ien a ion o he use and
inally, is MRI-condi ional which means i is speci ically designed
and es ed o ope a e sa ely in he unique en i onmen o a Magne ic
Resonance Imaging (MRI) scanne .
Pa icipan s
I. Pa ien s
a. A leas 18 yea s old.
b. Being diagnosed wi h PSPS and e ac o y o bes medical
ea men .
i. PSPS-T1, whe e no ( ele an ) su ge y was pe o med.
ii. PSPS-T2, su gical end s age a e one o se e al ope a i e
in e en ions on he lumba neu oaxis, indica ed o elie e lowe
back pain, adicula pain o he combina ion o bo h wi hou
posi i e e ec .
c. Ha ing ch onic pain ha exis s o a leas 6 mon hs wi h a pain
in ensi y o 5 o highe measu ed on nume ic a ing scale
d. Recei ed he selec ed INS pe s anda d o ca e and local
equi emen s and
e. T ea men o ch onic pain has been s abilized.
II. Heal h ca e p o essionals, who ea ed he pa ien s ha a e
included in his su ey.
Si es ha we e candida e o pa icipa e in his su ey
we e selec ed based on he ollowing c i e ia
i. loca ed in Eu ope
ii. SCS olume (> 10 SCS implan s o PSPS pe yea )
iii. using al eady he selec ed INS
i . inclusion o a leas 4 pa ien s (due o agg ega e da a collec ion
equi emen s)
. da a om exis ing da abase o easily e ie able om pa ien
iles
Da a collec ion
The sponso p o ided he pa icipa ing si es wi h an agg ega ed
da a collec ion ool ha is an Excel ile able o au oma ically gene a e
epo s o agg ega ed da a. The si e’s clinical s a independen ly
collec ed and manually en e ed pa ien da a in o he ool ha
au oma ically popula ed he summa y epo s wi h he da a agg ega ed.
The si e p o ided only he agg ega ed epo s o he sponso .
Collec ed da a consis ed o ( he comple e lis o da a i ems is
shown in Table 1):
i. Demog aphic pa ame e s (e.g., age, gende , indica ion o SCS)
ii. Technical de ails SCS (e.g., lead model, INS placemen ,
s imula ion wa e o m, ba e y)
iii. P og amming da a (e.g., # ca hodes and anodes, s imula ion
pa ame e s)
i . Pa ien epo ed ou comes and sa is ac ion (e.g., pain change,
goal achie emen , wo k)
. HCP su ey (e.g., INS MRI condi ionali y, INS size)
Fi e agg ega ed epo s (Demog aphics, Technical De ails,
P og amming G oup, Ou comes, HCP Su ey) we e signed by he si e
da a collec o and submi ed elec onically o he p ojec sponso . The
da a collec ed was agg ega ed, he e o e no indi idual pa ien da a
we e iden i iable om he epo p o ided.
S a is ical me hods
Desc ip i e s a is ics we e used o summa ize he da a collec ed
in he si e agg ega ed epo s. Con inuous a iables a e summa ized
by compu ing mean and s anda d de ia ion,1 minimum, maximum.
Ca ego ical a iables we e summa ized wi h coun s and pe cen ages.
Summa y s a is ics a e epo ed wi h maximum 1 decimal, as
app op ia e. The R so wa e, e sion 4.3.1, (R Founda ion, Vienna,
AT) was used.
E hics/IRB
Submission o he E hics commi ee was done, depending on he
local equi emen . Da a we e p o ided o he sponso in an agg ega ed
and ully anonymized o ma . In case eques ed by he local e hics
boa d, he si es we e p o ided wi h a da a elease o m ha should be
signed by he pa ien p io o da a collec ion.
Resul s
Su ey da a om 124 pa ien s we e collec ed a 9 hospi als/pain
clinics. Table 2 summa izes he pa ien s’ demog aphic and medical
his o y da a. On a e age he pa ien s we e 54.3 yea s old and had
ch onic pain o 9.9 yea s. Mos pa ien s we e emale (55.6%). The
indica ion PSPS o SCS was mainly o o e all back and leg pain
(68.5%) bu also leg pain (22.6%) and back pain (8.9%). Almos all
subjec s had p io back su ge y (91.1%) o PSPS-T2, wi h 79.8%
o pa ien s ha ing had be ween 1 and 3 su ge ies. Ele en pa ien s
(8.9%) had had no p io back su ge y (PSPS-T1). Table 3 shows
he summa y on echnical de ails. The a e age ime be ween SCS
implan a ion and clinical su ey da a cap u e was 931.6 days, o
app oxima ely 2.6 yea s. Some pa ien s may ha e had ano he INS
model p io o ecei ing he INS being in es iga ed. O all pa ien s,
101 had pe cu aneous leads and 23 had a su gical lead implan ed.
Mos pa ien s (70.2%) had 2 pe cu aneous leads implan ed and o
he majo i y placed in he median posi ion (66.9%), ollowed by he
pa amedian (29.8%) posi ion. The INS was placed o mos pa ien s
in he glu eal egion (51.6%) bu also he abdominal (27.4%) and he
lank (21%) egion.
1The combined s anda d de ia ion o all epo s is compu ed as he squa e oo
o he weigh ed mean o he sums o he a iance and he squa ed di e ence
be ween he si e mean and he o e all mean.
Objec i e se up desc ip ion and sa is ac ion assessmen o spinal co d s imula ion o ea men o
ch onic back and leg pain 22
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©2025 Seoane e al.
Ci a ion: Seoane FJC, Ga cía JCLP, Fou SD, e al. Objec i e se up desc ip ion and sa is ac ion assessmen o spinal co d s imula ion o ea men o ch onic
back and leg pain. In Phys Med Rehab J . 2025;10(1):20‒25. DOI: 10.15406/ipm j.2025.10.00392
Table 2 Demog aphic and Medical His o y (n=124 o o he wise s a ed)
Cha ac e is ic Value
Age
Mean (SD); Min-Max (y) 54.3 (11.2); 33-86
Gende
Male (% (n/P s)) 44.4 (55/124)
Female (% (n/P s)) 55.6 (69/124)
Indica ion o SCS
Pain (% (n/P s)) 22.6 (28/124)
Back Pain (% (n/P s)) 8.9 (11/124)
O e all Pain (% (n/P s)) 68.5 (85/124)
P io back su ge y
Yes (% (n/P s)) 91.1 (113/124)
No (% (n/P s)) 8.9 (11/124)
Numbe o back su ge ies
0 (% (n/P s)) 8.9 (11/124)
1 (% (n/P s)) 29 (36/124)
2 (% (n/P s)) 36.3 (45/124)
3 (% (n/P s)) 14.5 (18/124)
4 (% (n/P s)) 4 (5/124)
5 (% (n/P s)) 3.2 (4/124)
6 (% (n/P s)) 4 (5/124)
Du a ion o ch onic pain (n=123)
Mean (SD); Min-Max (y) 9.9 (6); 1-20
Spinal co d s imula ion p og amming
The s imula ion modes used we e highe ene gy wa e o ms
(65.3%) o con en ional/ onic s imula ion (34.7%), and pa es hesia
sensa ions we e el in 38.7% o cases. Figu e 1 shows he
p og ammed con ac loca ion o he back (Top) and leg (Bo om)
pain. Fo he ea men o back pain, he a ge cen e ed a ound T9
wi h a dis ibu ion be ween mid T8 and disc T9/T10. Fo he ea men
o leg pain, howe e , he a ge cen e ed nea mid T8. F om he eigh
possible di e en p og amming g oup op ions (A-H), g oup A was
used by mos pa ien s (86.3%). This g oup had 4 p og ams in 50.8%
o he cases and was used 74.4% o he ime. Two o he p og ammed
g oups (B and C) we e used by 52.4% and 46.8% o pa ien s,
espec i ely. Table 4 summa izes o mos used g oup (p og am g oup
A), he ac i e numbe o ca hodes and anodes, s imula ion in ensi y,
pulse du a ion and s imula ion equency. On a e age, pa ien s had
hei s imula ion on du ing 95% o he ime. Da a based on he las
10 echa ges showed an a e age neu os imula o cha ge du a ion
o 41.4 minu es once pe 2.7 days. 45.3% (39/86) o pa ien s had
he Accele ome e O ien a ion in he neu os imula o ac i a ed and
da a on posi ion ends we e a ailable om 32 pa ien s (Table 3).
The mean pe cen age ime pa ien s we e in he ollowing posi ions:
up igh , mobile, eclining, and all lying, we e, 37%, 3.4%, 8.5% and
51.2% espec i ely.
Table 3 Technical de ails
Cha ac e is ic Value
Time since SCS implan a ion (n=123)
Mean (SD); Min-Max (d) 931.6 (1622.2); 27-8813
Leads Model
Pe cu aneous (% (n/P s)) 81.4 (101/124)
Su gical (% (n/P s)) 18.6 (23/124)
Numbe o implan ed leads
1 (% (n/P s)) 29.8 (37/124)
2 (% (n/P s)) 66.9 (83/124)
Lead Placemen
Pa amedian (% (n/P s)) 29.8 (37/124)
Median (% (n/P s)) 66.9 (83/124)
INS ana omical posi ion
Abdomen (% (n/P s)) 27.4 (34/124)
Glu eal (% (n/P s)) 51.6 (64/124)
Flank (% (n/P s)) 21 (26/124)
S imula ion mode
Con en ional/ onic (% (n/P s)) 34.7 (43/124)
Highe ene gy (e.g., DTM) (% (n/P s)) 65.3 (81/124)
Pa es hesia Sensa ion
Yes (% (n/P s)) 38.7 (48/124)
No (% (n/P s)) 61.3 (76/124)
Accele ome e O ien a ion
Yes (% (n/P s)) 45.3 (39/86)
No (% (n/P s)) 54.7 (47/86)
Adap i eS im Use
Yes (% (n/P s)) 25.8 (32/124)
No (% (n/P s)) 74.2 (92/124)
Posi ion ends
Up igh Time (Mean (SD); Min-Max) 37.0 (11.1) 19-66
Mobile Time (Mean (SD); Min-Max) 3.4 (1.9) 0-7
Reclining Time (Mean (SD); Min-Max) 8.5 (6.0) 1-29
All Lying Time (Mean (SD); Min-Max) 51.2 (12.6) 26-75
Table 4 P og amming
P og am 1 P og am 2 P og am 3 P og am 4
Ac i e ca hodes (-) 1.1 (0.6); 0-4 0.8 (0.6); 0-4 0.6 (0.5); 0-1 0.5 (0.5); 0-2
Mean (SD); Min-Max (n)
Ac i e anodes (+) 1.3 (0.9); 0-6 0.9 (1.1); 0-8 0.6 (0.5); 0-2 0.5 (0.5); 0-2
Mean (SD); Min-Max (n)
In ensi y n3.6 (1.9); 2.8 (1.4); 2.6 (1.4); 2 (1.2);
Mean (SD); Min-Max; (mA) 0.4-12.8; 115 0.2-6.8; 88 0.2-7.7; 73 0.7-6.5; 67
Pulse du a ion 169.7 (147.7); 221.3 (101.6); 174.6 (39.2); 170.4 (4);
Mean (SD); Min-Max; n (µs) 90-500; 116 170-750; 89 170-480; 74 170-200; 68
Cu en F equency 65 (101.4); 274.5 (102.2); 293.1 (44.4); 296.3 (33.7);
Mean (SD); Min-Max; n (Hz) 5-1000; 116 40-300; 89 40-300; 74 50-300; 68
S imula ion On Time 94.8 (14); 0-100; 119
Mean (SD); Min-Max; n (%)
Recha ge Du a ion 41.4 (17.2); 8-95; 124
Mean (SD); Min-Max; n (minu es)
Recha ge F equency 2.7 (2.4); 0.4-13; 123
Mean (SD); Min-Max; n (pe .. d)
Objec i e se up desc ip ion and sa is ac ion assessmen o spinal co d s imula ion o ea men o
ch onic back and leg pain 23
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©2025 Seoane e al.
Ci a ion: Seoane FJC, Ga cía JCLP, Fou SD,e al. Objec i e se up desc ip ion and sa is ac ion assessmen o spinal co d s imula ion o ea men o ch onic
back and leg pain. In Phys Med Rehab J . 2025;10(1):20‒25. DOI: 10.15406/ipm j.2025.10.00392
Figu e 1 Con ac Loca ions o ea ing Back pain ( op) and Leg pain (bo om).
Pa ien epo ed ou comes
The summa y on ou comes a e shown in Table 5. Pa ien s epo ed
a mean imp o emen in pain o 70.4%. One hund ed and en pa ien s
(88.7%) had a p ede ined unc ional goal p io o s a ing SCS. A
he ime o he su ey pa ien s epo ed an imp o emen in hei
p ede ined goals o 75.4%. Fu he mo e, pain medica ion was educed
in 102 (82.3%) pa ien s and 32 pa ien s (25.8%) e u ned o wo k.
Figu e 2 shows he pa ien sa is ac ion ou comes. Pa ien sa is ac ion
o ea men o pain a ed as “Somewha sa is ied, Sa is ied o Ve y
sa is ied” was epo ed by 116 (93.6%) pa ien s. 116 (93.6%), 113
(91.1%) and 103 (83.1%) pa ien s we e “Somewha sa is ied, Sa is ied
o Ve y sa is ied” o espec i ely echa ge ease, echa ging ime and
echa ge equency.
Table 5 Ou comes
Cha ac e is ic Value
Pain Imp o emen (n=123)
Mean (SD); Min-Max (%) 70.4 (17.2); 10-100
Did he pa ien ha e a p ede ined unc ional goal
o SCS?
Yes (% (n/P s)) 88.7 (110/124)
No (% (n/P s)) 11.3 (14/124)
I Yes, P ima y Goal Indica ed:
Exe cise/S anding/Walking (% (n/P s)) 19.1 (21/110)
Household (% (n/P s)) 0.9 (1/110)
T a el/D i e/A end Ac i i ies (% (n/P s)) 10 (11/110)
Sel -Ca e/Quali y o Li e (% (n/P s)) 25.5 (28/110)
Spo s/Dog Walking/Biking (% (n/P s)) 4.5 (5/110)
Pain/Medica ion Reduc ion (% (n/P s)) 36.4 (40/110)
Sleep Rela ed (% (n/P s)) 3.6 (4/110)
Imp o emen eached o he goal (n=110)
Mean (SD); Min-Max (%) 75.4 (17.2); 20-100
Reduc ion in Pain Medica ion
Yes (% (n/P s)) 82.3 (102/124)
No (% (n/P s)) 17.7 (22/124)
Re u n o wo k
Yes (% (n/P s)) 25.8 (32/124)
No (% (n/P s)) 74.2 (92/124)
Re u n o wo k
Full Time (% (n/P s)) 50 (16/32)
Pa -Time because o pain (% (n/P s)) 37.5 (12/32)
Pa -Time (% (n/P s)) 12.5 (4/32)
Figu e 2 Pa ien sa is ac ion: % (n=124).
Heal h ca e p o essional sa is ac ion
Figu e 3 ep esen s HCP sa is ac ion. HCPs we e “Sa is ied o Ve y
Sa is ied”, in 98.0% o he MRI condi ionali y o he INS, in 96.8%
o he size o he INS, in 94.9% o use o he objec i e o ien a ion
da a and in 92.7% o SCS p og amming ease.
Objec i e se up desc ip ion and sa is ac ion assessmen o spinal co d s imula ion o ea men o
ch onic back and leg pain 24
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©2025 Seoane e al.
Ci a ion: Seoane FJC, Ga cía JCLP, Fou SD, e al. Objec i e se up desc ip ion and sa is ac ion assessmen o spinal co d s imula ion o ea men o ch onic
back and leg pain. In Phys Med Rehab J . 2025;10(1):20‒25. DOI: 10.15406/ipm j.2025.10.00392
Figu e 3 Heal h ca e p o essional sa is ac ion: % (n/Resp).
Discussion
The pa ien s included in he CS had a simila age and du a ion o
ch onic pain as epo ed in o he s udies.1–8 Mos pa ien s (74%) in he
CS ecei ed SCS a e 0-2 spine su ge ies. The pa ien s desc ibed in
his CS demons a ed e ec i e supp ession o back and/o leg pain,
e en o e longe pe iods o ime, as is indica ed by he wide ange o
da a cap u e since SCS onse (up o 8813 days a e SCS implan ). The
pain supp ession by SCS was accompanied by an o e all educ ion
in pain medica ion in mo e han 80% o pa ien s. Apa om hese
bene i s, pa ien s addi ionally showed an imp o emen o 74% in
achie ing hei goals o li ing, and a qua e o pa icipan s e u ned
o wo k. These bene i s and imp o emen s a e in line wi h wha has
been epo ed in con olled s udies and egis ies.15–17 Finally, hese
ou comes a e e lec ed in he high o e all sa is ac ion wi h SCS by
hese pa ien s. Op imiza ion o SCS he apy has been shown in ea lie
s udies ( egis ies) o equi e a pa ien indi idual app oach. This
may be pa ly due o ana omical (physiological) di e ences be ween
subjec s, as is illus a ed by he a ia ion in he ana omical a ge o
bo h ea ing he back pain componen and he leg pain componen
(Figu e 1). Addi ionally, ea men o he p edominan pain indica ion,
such as leg pain o back pain, may equi e speci ic wa e o ms.
Examples a e lowe ene gy wa e o ms, such as onic/con en ional
s imula ion egula ly used o leg pain o highe ene gy wa e o ms,
such as DTM ha a e commonly used o back and back-and-leg
pain.1–4,11–17 The pa ien s’ indi idual app oach is u he illus a ed
by he a ia ion in p og amming, such as he numbe o p og ams
o accommoda e speci ic needs du ing he day, and s imula ion
pa ame e s ( equencies, pulse du a ions and ampli udes).
The INS used in his CS demons a ed lexibili y o pa ien s wi h
PSPS, who a e ea ed wi h SCS. The majo i y o pa ien s we e using
high ene gy wa e o ms. Due o he highe ene gy equi emen s,
pa ien s need o echa ge hei INS mo e o en compa ed o onic,
low ene gy s imula ion. Howe e , he ease o echa ging he INS
and he ime o echa ge he INS we e widely accep ed by pa ien s,
as illus a ed by hei use sa is ac ion. Use o he de ice o hese
pa ien s was well ecognized and app ecia ed by he heal h ca e
p o essionals who implan and/o p og am he SCS de ices. Bo h he
size o he INS and he MRI condi ionali y, i.e. he limi ed numbe
o condi ions o a pa ien o ecei e and MRI we e highly alued,
simila ly as he ease o p og amming and in o ma ion p o ided by he
Snapsho epo . The la e can p o ide objec i e da a on he pa ien ’s
unc ional ac i i ies.18 O e all, he CS has shown o be an e ec i e
ool o p o ide a c oss-sec ional o e iew o he use o SCS o a
speci ic pa ien popula ion and neu os imula o de ice.
Conclusion
This CS shows ha SCS is o e ed in a s anda dized me hod
ac oss pain clinics in Eu ope and desc ibes use expe iences, he apy
ou comes and de ice se ings om pa ien s who use his he apy o
ea men o ch onic e ac o y pain.
Limi a ions
This is a desc ip i e analysis pe o med on a selec ed se o
clinicians. Acco ding o he na u e o e ospec i e/p ospec i e
obse a ional esea ch da a and since he sponso can’ moni o he
single pa ien da a included selec ion bias could be possible.
Acknowledgmen s
The esea ch p ojec was sponso ed by Med onic. The
pa icipa ing hospi als and clinics ecei ed inancial compensa ion
o he ime spen on da a collec ion and en y. HH, CS and RB a e
Med onic employees.
Con lic s o in e es
The au ho s decla e ha he e a e no con lic s o in e es .
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