Skip to main content

11-15-2017 | Neuropathy | News

Spinal cord stimulation efficacy sustained in patients with diabetic polyneuropathy


medwireNews: Patients with painful diabetic polyneuropathy continue to experience pain relief in the lower extremities for at least 5 years of spinal cord stimulation (SCS), suggest study findings.

The researchers found that SCS was successful in 86% of 36 patients 1 year after receiving a permanent implant and in 55% of 22 patients after 5 years, and survival analysis estimated that 80% of patients still used their SCS device after 5 years.

“Because SCS treatment is maintained over at least 5 years in patients with [painful diabetic polyneuropathy] and >50% of patients still use their initial SCS device after 5 years, SCS can be considered a cost-effective long-term treatment modality in patients with [painful diabetic polyneuropathy],” says the team.

Treatment success was based on achieving at least a 50% decrease in day or night numerical rating scale (NRS) pain score or a Patient’s Global Impression of Change (PGIC) score of 6 or above (much improved or very much improved).

Specifically, at 5 years, average NRS scores had decreased from 6.7 at baseline to 4.3 during the day and 4.6 during the night, and 36% and 32% of patients had achieved at least a 50% reduction in day and night scores, respectively.

PGIC improvement for pain and sleep was seen in a corresponding 50% and 32% of patients after 5 years.

Maarten van Beek (Maastricht University Medical Center, the Netherlands) and colleagues note in Diabetes Care that no associations were observed between baseline factors and SCS success, but a higher baseline Michigan Diabetic Neuropathy Score (MDNS) was significantly associated with SCS failure, increasing the risk for subsequent removal of the system 3.9-fold.

The researchers stress, however, that despite this association, 40% of patients with the highest MDNS still used their SCS device after 5 years.

“Therefore, patients with [painful diabetic polyneuropathy] with a high mean MDNS should not be deprived of SCS treatment,” they say.

“However, the results can help to inform patients with [painful diabetic polyneuropathy] who are seeking SCS treatment.”

Conversely, there was also a significant, albeit modest, association between higher NRS scores at night and a reduced risk for treatment failure, which van Beek and colleagues attribute to “the therapeutic window for SCS being smaller with a lower baseline pain score.”

By Lucy Piper

medwireNews is an independent medical news service provided by Springer Healthcare. © 2017 Springer Healthcare part of the Springer Nature group


Be confident that your patient care is up to date

Medicine Matters is being incorporated into Springer Medicine, our new medical education platform. 

Alongside the news coverage and expert commentary you have come to expect from Medicine Matters diabetes, Springer Medicine's complimentary membership also provides access to articles from renowned journals and a broad range of Continuing Medical Education programs. Create your free account »