Coronal Spinal Deformity Does Not Predict Clinical Response to Thoracic Spinal Cord Stimulation

Area of Science:

• Neurosurgery
• Spinal Surgery
• Pain Management

Background:

• Coronal spinal deformity is frequent in patients receiving spinal cord stimulation (SCS).
• Deformity may complicate SCS lead placement and programming.
• The impact of coronal alignment on SCS clinical response is not well understood.

Purpose of the Study:

• To assess the association between thoracic and lumbar coronal deformity and one-year SCS outcomes.
• To determine if spinal alignment influences patient response to SCS therapy.

Main Methods:

• Retrospective cohort study of adult patients undergoing thoracic SCS.
• Measurement of thoracic and lumbar Cobb angles on perioperative radiographs.
• Logistic regression analysis to evaluate associations between Cobb angles and one-year responder status (≥50% pain reduction).

Main Results:

• No significant association was found between thoracic or lumbar Cobb angles and one-year SCS responder status.
• Neither continuous nor dichotomized Cobb angles independently predicted SCS response in adjusted analyses.
• Exploratory analyses indicated potential modest geometry-dependent effects in specific contexts, but overall conclusions remained unchanged.

Conclusions:

• Coronal deformity severity was not associated with short-term response to thoracic SCS in this cohort.
• Spinal deformity should not be a criterion for excluding patients from SCS.
• Further research may explore subtle geometry-dependent effects in specific patient subgroups.