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Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation
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Differential Target Multiplexed Spinal Cord Stimulation in Persistent Spinal Pain Syndrome Type II: A Multicenter

Alfonso Papa1, Vincenzo Desiderio2, Grazia Armento3

  • 1Pain Therapy Unit (UOC Terapia Antalgica), AORN Ospedali dei Colli, Monaldi Hospital, Naples, Italy.

Neuromodulation : Journal of the International Neuromodulation Society
|May 20, 2026
PubMed
Summary

Differential target multiplexed spinal cord stimulation (DTM-SCS) effectively reduced pain and improved function in patients with persistent spinal pain syndrome type II (PSPS-II). Biomarker analysis indicated potential for personalized treatment approaches.

Keywords:
Chronic neuropathic paindifferential target multiplexed spinal cord stimulationinflammatory biomarkerspersistent spinal pain syndrome type IIreal-world evidence

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Area of Science:

  • Neuromodulation
  • Pain Management
  • Neuroscience

Background:

  • Chronic pain, particularly persistent spinal pain syndrome type II (PSPS-II), significantly impacts quality of life.
  • Neuroglial interactions are implicated in the pathophysiology of chronic pain.
  • Novel neuromodulation techniques are needed to address complex pain conditions.

Purpose of the Study:

  • To evaluate the real-world effectiveness of differential target multiplexed spinal cord stimulation (DTM-SCS) in patients with PSPS-II.
  • To assess DTM-SCS's impact on pain intensity, functional disability, neuropathic symptoms, pain catastrophizing, and quality of life.
  • To explore the relationship between early inflammatory biomarker modulation and treatment response heterogeneity.

Main Methods:

  • Prospective, multicenter, observational cohort study involving 71 adult patients with PSPS-II and severe low back pain.
  • Patients received DTM-SCS, with outcomes assessed at baseline and 4, 12, and 24 weeks.
  • Peripheral inflammatory cytokines were measured, and cluster analysis was performed to identify patient subgroups.

Main Results:

  • Significant reductions in pain intensity (Numeric Rating Scale) were observed from baseline to 12 and 24 weeks (p < 0.0001).
  • Over 50% of patients achieved at least a 50% pain reduction at 12 weeks.
  • Improvements were noted in functional disability, neuropathic pain, pain catastrophizing, and quality of life (all p < 0.0001).
  • Exploratory analysis revealed three patient clusters, with one showing coordinated cytokine modulation and greater pain reduction (p = 0.025).

Conclusions:

  • DTM-SCS demonstrated sustained efficacy in improving pain, function, and patient-reported outcomes for PSPS-II in a clinical setting.
  • The safety profile of DTM-SCS was comparable to established spinal cord stimulation therapies.
  • Biomarker findings suggest interindividual variability in treatment response, highlighting potential for personalized neuromodulation strategies.