Long-term efficacy of neuromodulation in chronic pain management: a single-center retrospective study

Neuromodulation is an advanced therapy for managing chronic pain by modulating nerve activity through electrical stimulation. This study evaluates the clinical outcomes of neuromodulation therapies, including spinal cord stimulation (SCS), occipital nerve stimulation (ONS), and peripheral nerve field stimulation (PNFS) in patients with refractory chronic pain.

A retrospective analysis was conducted at the Department of Neurosurgery, Department of Neurosurgery, University Hospital Olomouc, on 70 patients who underwent neuromodulation therapy between 2019 and 2024. Indications included Persistent Spinal Pain Syndrome Type 2 (PSPS-T2), Persistent Spinal Pain Syndrome Type 1 (PSPS-T1), Complex Regional Pain Syndrome (CRPS), Failed Neck Surgery Syndrome, and neuropathic pain. Pain relief was assessed using the Visual Analog Scale (VAS) before and after implantation. Only patients with a successful trial stimulation who proceeded to permanent implantation were included in the analysis, and outcomes aree therefore interpreted as descriptive results in a responder-selected cohort.

Patients experienced significant pain reduction post-implantation. Among PSPS-T2 patients (n = 40), mean VAS scores decreased from 5.58 to 1.80 (67.2% reduction). Similar trends were observed in PSPS-T1 (64.5% reduction), CRPS (85% reduction), and other conditions, with an overall mean pain reduction of 58.3%. Percutaneous electrodes and non-rechargeable implantable pulse generators (IPGs) were most commonly used.

In this single-center, retrospective real-world cohort, neuromodulation was associated with clinically meaningful pain reduction among patients who responded to trial stimulation. These data primarily illustrate contemporary neuromodulation practice and outcomes in a Central European academic center.