Long-Term Effectiveness of Spinal Cord Stimulation Beyond 24 Months: A PRISMA-ScR-Informed Scoping Review

Area of Science:

• Neurology
• Pain Management
• Medical Technology Assessment

Background:

• Spinal cord stimulation (SCS) is a recognized therapy for chronic pain.
• Clinical value hinges on sustained benefits beyond the initial post-implantation phase.
• Existing long-term SCS studies (≥24 months) are fragmented and methodologically diverse.

Purpose of the Study:

• To map the existing clinical literature on SCS outcomes at 24 months or longer.
• To characterize patient populations, SCS modalities, and assessed outcomes.
• To identify gaps in the long-term SCS evidence base.

Main Methods:

• A PRISMA-ScR-informed scoping review was conducted.
• Searches of PubMed/MEDLINE and Scopus databases were performed up to April 2026.
• 65 unique reports representing 11,518 participants were included after rigorous screening.

Main Results:

• The majority of evidence (55/65 reports) was non-randomized.
• Mixed chronic pain and failed back surgery syndrome/persistent spinal pain syndrome were the most common indications.
• Long-term benefits were more frequently supported than complete loss of effect, particularly in spinal pain and newer technologies.

Conclusions:

• Durable SCS benefit is achievable for a significant patient subset, notably in spinal pain syndromes and with contemporary technologies.
• The current evidence is heterogeneous, precluding uniform conclusions across all indications and SCS platforms.
• Future research should focus on indication-specific cohorts and standardized outcome reporting.