Effects of Spinal Cord Stimulation in Patients with Small Fiber and Associated Comorbidities from Neuropathy After Multiple Etiologies

J. Clin. Med., 2025 · DOI: https://doi.org/10.3390/jcm14020652 · Published: January 20, 2025

Simple Explanation

This study evaluated spinal cord stimulation (SCS) for chronic pain caused by peripheral neuropathy from various causes. Patients with diabetic, idiopathic, or chemotherapy-induced neuropathy received SCS and were followed for a year. The study found SCS significantly improved pain, neuropathic symptoms, sleep, functionality, and quality of life.

Study Duration

April 2023 to May 2024, with follow-ups at 2, 4, 6, and 12 months

Participants

19 patients suffering from the painful polyneuropathy of diverse etiologies: diabetic (DPN), idiopathic (CIAP), chemotherapy-induced (CIPN), and others

Evidence Level

Prospective single center observational longitudinal cohort study

Key Findings

1
SCS produced a significant consistent and sustained improvement in pain intensity by 49% in DN4 and 76% in VAS.
2
Neuropathic pain symptoms improved by 73%, autonomic symptoms by 26–30%, functionality by 44%, sleep by 74%, and quality of life (69% for EQ-VAS and 134% EQ-5D).
3
Distal intra-epidermal nerve fiber density improved by 22% at 12 months while proximal intra-epidermal nerve fiber density decreased by 18%.

Research Summary

The aim of this study was to evaluate the effects of spinal cord stimulation (SCS) on pain, neuropathic symptoms, and other health-related metrics in patients with chronic painful peripheral neuropathy (PN) from multiple etiologies. SCS produced a significant consistent and sustained improvement in pain intensity by 49% in DN4 and 76% in VAS, in neuropathic pain symptoms by 73%, in autonomic symptoms by 26–30%, in the sensorimotor physical exam by 8%, in functionality by 44%, in sleep by 74%, and in quality of life (69% for EQ-VAS and 134% EQ-5D). SCS is an effective therapy for managing various types of PN.

Practical Implications

Improved Symptom Management

SCS offers a non-pharmacological alternative for managing SFN symptoms, decreasing reliance on systemic medications and their associated risks.

Enhanced Quality of Life

Targeted pain relief through SCS can improve physical function and emotional well-being, enabling patients to engage more fully in daily activities.

Personalized Treatment Approach

SCS can be tailored to individual patient needs, aligning with modern trends towards individualized treatment plans for chronic pain.

Study Limitations

1
The primary limitation is the sample size.
2
The design of the study also includes the absence of a control group
3
The incomplete or interrupted follow-up of participants, leading to attrition and loss to follow-up over time

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