Both conventional and novel spinal cord stimulation therapies significantly outperformed conventional medical management in reducing chronic back and leg pain, according to a recent review.

In the systematic review and network meta-analysis, published in JAMA Network Open, investigators evaluated the efficacy of spinal cord stimulation (SCS) therapies compared with conventional medical management (CMM) for chronic back and leg pain. The analysis included 13 randomized clinical trials with 1,561 patients, assessing 6-month outcomes.

Both conventional and novel SCS therapies were more effective compared with CMM in improving several key outcomes. For responder rates (defined as at least 50% pain reduction), both SCS therapies outperformed CMM: conventional SCS had an odds ratio (OR) of 3.00 (95% credible interval [CrI] = 1.49–6.72) for back pain, whereas novel SCS showed a more significant OR of 8.76 (95% CrI = 3.84–22.31). Pain intensity reduction also favored SCS, with conventional SCS achieving a mean difference (MD) of −1.17 (95% CrI = −1.64 to −0.70) and novel SCS achieving a MD of −2.34 (95% CrI = −2.96 to −1.73) for back pain. For leg pain, novel SCS demonstrated the greatest reduction in pain intensity (MD = −4.01, 95% CrI = −5.31 to −2.75).

Quality of life, as measured by the EQ-5D index, improved significantly with both SCS therapies (conventional SCS: MD = 0.15; novel SCS: MD = 0.17). Additionally, patients receiving conventional SCS experienced greater reductions in functional disability, as assessed by the Oswestry Disability Index (MD = −7.10, 95% CrI = −10.91 to −3.36).

The review provided robust evidence supporting the effectiveness of both conventional and novel SCS therapies in managing chronic pain, with improvements in pain relief, quality of life, and functional outcomes. However, the study's limitations, including potential bias and the lack of long-term safety data, warranted cautious interpretation. The findings emphasized the potential of SCS as a valuable treatment option for chronic back and leg pain.

Full disclosures can be found in the published review.