ESRA19-0137 Two-year follow-up of a customized field shape using sub-perception spinal cord stimulation in a real-world, observational cohort of chronic pain patients

Background and aims Recently published data suggests that substantial pain relief can be achieved using sub-perception Spinal Cord Stimulation (SCS) within a wide range of frequencies and pulse-widths (Thomson et al. Neuromodulation. 2018). Contrary to traditional SCS which requires paresthesia mapping, sub-perception SCS can rely on an anatomically-guided bipolar search along the lead until the best patient-specific outcome is determined. Here, we present 2-year real-world outcomes utilizing a novel sub-perception based SCS algorithm for customizing field shape based on patient-specific anatomy and lead placement. Methods Patients (up to N=15) were assessed at a single center as part of an ongoing retrospective chart review of SCS outcomes for chronic pain (Clinicaltrials.gov: NCT01550575). a customized field shape (CFS) algorithm was designed to engage anti-nociceptive terminals over a broader coverage area versus an 8 mm bipole. a ‘sweet-spot search’ was performed spanning vertebral levels T8-T10. At follow-up, patients were asked to score their pain (NRS) using a set of predefined CFS programs. Duration of time in which patients could sit, stand and walk without unbearable pain was determined. Additionally, duration of time between charging sessions was calculated for each patient’s preferred program. Results Preliminary results (n = 15) reported previously indicated that pain was reduced on average by 68% (NRS=2.7, Δ=5.8) at six months, and by 72% at 1 year (NRS=2.4, Δ=6.1). Longer term data for this cohort is ongoing. Final results will be presented. Conclusions Precise customization of stimulation field shape for each patient can facilitate long-term sub-perception pain relief while reducing patient charge burden.