Experience of Spinal Cord Stimulation in Kaunas Clinics

Introduction Spinal cord stimulation (SCS) is a new, minimally invasive method for treating chronic lower back and/or limb pain in Lithuania. It is a procedure in which the patient is implanted with electrodes and a neurostimulator, the aim of which is to reduce the transmission of pain information to the central nervous system by stimulating A-beta fibres. This treatment method can help relieve chronic back and limb pain after one or more spinal surgeries and ineffective medical and interventional pain management. Successful spinal cord stimulation not only reduces pain but also improves emotional and physical well-being [1, 2, 3]. Aim To evaluate the clinical effectiveness of spinal cord stimulation in reducing chronic pain and improving quality of life in patients treated at Kaunas Clinics. Methods The retrospective study includes 29 patients who were evaluated in 2024 by a multidisciplinary team at the Pain Management Unit of LUHS KC for test SPS. Demographic and perioperative patient data from ambulatory health records (pain localization, intensity, etc.) were evaluated. DN4 (Neuropathic Pain Diagnostic Questionnaire), ODI (Disability Questionnaire) and HAD (Anxiety and Depression Scale) questionnaire results were also included. IBM SPSS Statistics 30.0 and MS Excel 2021 were used for statistical analysis. In this study, statistical analysis was performed to assess the changes before and after spinal cord stimulation. The nonparametric Wilcoxon signed-rank test was used due to the very small sample size to determine whether there were significant differences after treatment. Results SCS is considered effective when the patient's perceived pain is reduced by more than 50%. By 2024-12-01, 8 patients successfully underwent SCS implantation. Their mean age was 59 ± 12.3 years. All patients had prior medication treatment, 87.5% (n=7) had undergone surgical treatment, and 100% (n=8) had received ineffective invasive pain management. Pre-SCS pain intensity in implanted patients was 8.4 ± 1.9 during movement. During the trial SCS phase, pain intensity decreased by 57.4% (to 3.6 ± 1.6 (Wilcoxon test p < 0.05)). At the 1-month followup (n=4), the mean pain score was 3.25 ± 2.8, indicating sustained pain reduction. DN4, ODI, and HAD assessments before SCS indicated neuropathic pain, severe disability, and high depression scores. At the 1-month follow-up (n=5), a positive trend was observed: DN4 decreased from 5.75 to 2 points, ODI from 65% to 44.4%, HAD-D from 9.7 to 5.5 points, and HAD-N from 10.7 to 5.25 points. However, these changes were not statistically significant (Wilcoxon test, p > 0.05). Conclusions This study demonstrates that SCS is an effective treatment for chronic low back pain, leading to significant pain reduction in (p < 0.05). Although improvements in disability and psychological scores were observed, they were not statistically significant. Larger scale studies are needed to further validate these findings.