AAPM Logo Those suffering from low back pain and not found relief through conventional spinal cord stimulation (SCS) can supposedly benefit from the following device. Scientists have now designed a unique device that eases pain in patients with low back pain. The newly invented spinal neuromodulation device probably works to achieve paresthesia that alters the pain sensation into a ‘pins and needles’ or tingling sensation through stimulation of certain pain pathways.

The study encompassed 30 patients with and without previous spine surgery who had an average back pain Visual Analog Score (VAS) of 8 out of 10 and an average leg pain VAS score of 6 out of 10. After approval from an ethics committee and the completion of a successful trial, dual octapolar, percutaneous leads were placed sequentially near the anatomic midline. This anatomic midline is between T8-T11 points which are allegedly present in the thoracic area of the spinal column. The Nevro system device was connected to a rechargeable Implantable Pulse Generator (IPG) capable of delivering waveforms with frequencies up to 10 kHz.

On completion of three months, the average VAS score for back pain seemingly dropped to 2.9 and the average VAS score for leg pain fell to 2.2. At six months the average back and leg pain VAS scores purportedly fell to 1.6 respectively. Also the Oswestry Disability Index (ODI) was put to use for measuring how back pain affected patient’s everyday life. The ODI apparently declined from 61 to 44. Authors pointed out that the device was capable of providing significant pain relief at six months for both back and leg pain.

“To date there is no evidence that any of these techniques provide persistent long term pain relief at the lower back. Nevro Spinal Cord Stimulation is the cutting edge in implant technology which certainly is going to make a major difference in the management of persistent lower back pain,” commented Dr Adnan Al-Kaisy MB ChB FRCA, Clinical Lead of the Pain Management and Neuromodulation Centre, Guy’s and St Thomas’ Hospital, London, UK. “Using unique super high frequency stimulation, it suppresses the sparse fibers of the lower back, at the spinal cord level. Moreover, the frequency is so high the patient does not feel ‘the tingling sensation’ which some patients find extremely uncomfortable and distressing.”

No need for intra-operative paresthesia mapping appeared with improvement in pain from the implantation of the device. The spinal neuromodulation was supposedly able to enhance patient function without movement-induced shocking and when the system was used overnight, the subjects reported improved sleep. The ultimate goal of spinal neuromodulation may be to achieve paresthesia, which modifies the pain sensation into a ‘pins and needles’ or tingling sensation through stimulation of specific pain pathways.

Even though SCS apparently is the preferred treatment for patients suffering with failed back syndrome surgery (FBSS), providing paresthetic coverage of the low back is difficult and clinical results are poor.

The study was presented at the American Academy of Pain Medicine’s 27th Annual Meeting.