Evaluating Outcomes of Sacral Neuromodulation in Patients With Multiple Sclerosis

OBJECTIVE: To evaluate the revision and removal rates of sacral neuromodulation (SNM) in patients with multiple sclerosis (MS) using a large national administrative dataset. METHODS: This was a retrospective cohort study using the Premier Healthcare Database. There were 13 913 patients analyzed between the years of 2006 and 2022), 218 of whom had diagnosis of MS. Patients were categorized into two groups as with MS and without any neurological disorders including MS (controls). The primary outcome was the relationship of MS on the 1- and 5-year device revision/removal rates. Secondary outcomes were associated complication rates within 1 year and beyond 1 year, the association between type of antibiotic prophylaxis and infectious complications. RESULTS: Patients with MS had similarly low rates of mechanical (within 1 year 1.8% vs. 2.1%; p = 0.98, and beyond 1 year 2.8% vs. 4.5%; p = 0.28), infectious (within 1 year 1.4% vs. 0.84%; p = 0.62, and beyond 1 year 0% vs. 0.29%; p = 0.88), and other complications (within 1 year 0.46% vs. 0.73%; p = 0.95, and beyond 1 year 0.46% vs. 0.93%; p = 0.71) within and beyond 1 year compared to controls, respectively. There was no statistically significant difference in revision/removal rates at 1 and 5 years between MS (11.2% and 29.9%) and for control patients (8.1% and 26.9%), respectively. In multivariable Cox proportional hazards models, MS was not found to be associated with removal/revision. CONCLUSION: Our results suggest that a diagnosis of MS does not appear to impact SNM associated revision/removal rates and is associated with similarly low rates of complications compared to patients without any neurologic condition.