ISPUB.com / IJNS/18/1/57065
  • Author/Editor Login
  • Registration
  • Facebook
  • Google Plus

ISPUB.com

Internet
Scientific
Publications

  • Home
  • Journals
  • Latest Articles
  • Disclaimers
  • Article Submissions
  • Contact
  • Help
  • The Internet Journal of Neurosurgery
  • Volume 18
  • Number 1

Editorial

Advancements in Spinal Cord Stimulation (SCS) Therapy: Embracing Closed Loop Technology

G K Matis

Citation

G K Matis. Advancements in Spinal Cord Stimulation (SCS) Therapy: Embracing Closed Loop Technology. The Internet Journal of Neurosurgery. 2024 Volume 18 Number 1.

DOI: 10.5580/IJNS.57065

Abstract
 

Editorial:

In the realm of chronic pain management, innovations continually emerge, offering hope and relief to those grappling with debilitating conditions. Among these advancements, spinal cord stimulation (SCS) therapy stands out as a beacon of promise, providing an alternative for individuals for whom traditional pain management approaches have fallen short. Now, with the integration of closed loop technology (CLT), SCS therapy takes a significant leap forward, enhancing efficacy and personalized care for patients.

CLT represents a paradigm shift in SCS therapy, enabling real-time adjustments based on the patient's physiological responses. Unlike conventional SCS systems that operate on fixed parameters, closed loop (CL) systems dynamically adapt to changes in the patient's pain levels and activity, optimizing therapeutic outcomes. This adaptive approach holds immense potential in improving pain relief, reducing reliance on medication, and enhancing patient satisfaction.

One of the primary advantages of CLT in SCS therapy is its ability to deliver tailored therapy that aligns with the patient's unique needs. By continuously monitoring physiological markers such as neural activity and patient movement, CL systems can precisely modulate stimulation parameters, maximizing pain relief while minimizing side effects. This individualized approach enhances the overall effectiveness of SCS therapy, offering hope to patients who have previously experienced suboptimal results.

Moreover, CLT has shown promising results in addressing the limitations of traditional SCS systems. Studies have demonstrated that CL systems lead to superior pain relief, greater patient satisfaction, and reduced incidence of therapy-related complications. For instance, recent clinical trials found that CL SCS resulted in significantly greater pain reduction compared to conventional SCS, with a higher proportion of patients achieving clinically meaningful improvements in pain scores.

Furthermore, CLT holds the potential to extend the longevity of SCS therapy devices. By optimizing stimulation parameters in real-time, these systems could mitigate the development of tolerance and adaptation, thereby prolonging the efficacy of treatment over time. This represents a significant advantage for patients, reducing the need for frequent device adjustments and replacements.

However, it is essential to acknowledge the potential challenges and limitations associated with CLT in SCS therapy. One concern is the complexity of these systems, which may require additional training for healthcare providers and meticulous programming to ensure optimal outcomes. Moreover, the cost of CL systems may pose a barrier to widespread adoption, particularly in healthcare systems with limited resources.

Despite these challenges, the integration of CLT marks a significant milestone in the evolution of SCS therapy. It represents a shift towards more personalized and adaptive approaches to pain management, offering new hope for patients with chronic pain conditions. Importantly, it is crucial to recognize that CLT is not a new waveform per se but rather a means of optimizing the delivery of existing waveforms available in the market. By harnessing the power of real-time feedback and adaptive control, CL SCS systems have the potential to revolutionize pain management and improve the quality of life for countless individuals worldwide.

References

Muller L, Pope J, Verrills P, Petersen E, Kallewaard JW, Gould I, Karantonis DM. First evidence of a biomarker-based dose-response relationship in chronic pain using physiological closed-loop spinal cord stimulation. Reg Anesth Pain Med. 2024; doi: 10.1136/rapm-2024-105346. Online ahead of print.
Mekhail NA, Levy RM, Deer TR, Kapural L, Li S, Amirdelfan K et al. ECAP-controlled closed-loop versus open-loop SCS for the treatment of chronic pain: 36-month results of the EVOKE blinded randomized clinical trial. Reg Anesth Pain Med. 2023; doi: 10.1136/rapm-2023-104751. Online ahead of print.
Leitner A, Hanson E, Soliday N, Staats P, Levy R, Pope J, et al. Real World Clinical Utility of Neurophysiological Measurement Utilizing Closed-Loop Spinal Cord Stimulation in a Chronic Pain Population: The ECAP Study Protocol. J Pain Res. 2023; 16:2497-2507. doi: 10.2147/JPR.S411927.
Kapural L, Mekhail NA, Costandi S, Gilmore C, Pope JE, Li S, et al. Durable multimodal and holistic response for physiologic closed-loop spinal cord stimulation supported by objective evidence from the EVOKE double-blind randomized controlled trial. Reg Anesth Pain Med. 2024; 49(4):233-240. doi: 10.1136/rapm-2023-104639.

Author Information

Georgios K. Matis, MD, MSc, PhD, FINR(CH)
Head of Pain / Spasticity Section, Department of Stereotactic & Functional Neurosurgery, University Cologne Hospital
Cologne, Germany
georgios.matis@uk-koeln.de

Download PDF

Your free access to ISPUB is funded by the following advertisements:

 

BACK TO TOP
  • Facebook
  • Google Plus

© 2013 Internet Scientific Publications, LLC. All rights reserved.    UBM Medica Network Privacy Policy