High-density in Spinal Cord Stimulation: Virtual Expert Registry

Overview

This is a prospective, multi-center, observational follow-up study observing the effectiveness of high density spinal cord stimulation in patients with failed back surgery syndrome patients with back and leg pain.

Study Type

  • Study Type: Observational [Patient Registry]
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: December 8, 2020

Detailed Description

DISCOVER will measure the effectiveness of high-density spinal cord stimulation for treatment of chronic back and leg pain. Identification of clinical effective parameters concerning location of active electrodes, frequency, pulse duration, amplitude and battery consumption are, besides safety, the major outcome parameters of this study.

Interventions

  • Device: spinal cord stimulation

Arms, Groups and Cohorts

  • spinal cord stimulation
    • Failed back surgery syndrome patients will receive high density spinal cord stimulation

Clinical Trial Outcome Measures

Primary Measures

  • Pain intensity with the Numeric Rating Scale (NRS)
    • Time Frame: The difference between the baseline screening and the evaluation 1 month after high density stimulation, 3 months and 12 months.
  • Pain relief by pain medication
    • Time Frame: The difference between the baseline screening and the evaluation 1 month after high density stimulation, 3 months and 12 months.
    • Questionnaire regarding the amount of pain relief by pain medication
  • The abilities in daily living
    • Time Frame: The difference between the baseline screening and the evaluation 1 month after high density stimulation, 3 months and 12 months.
    • The functional abilities will be assessed with the Oswestry Low Back Pain Questionnaire.
  • The current health status
    • Time Frame: The difference between the baseline screening and the evaluation 1 month after high density stimulation, 3 months and 12 months.
    • The health status will be observed with the Euroqol (EQ-5D-5L) questionnaire.
  • Subjective sleep quality
    • Time Frame: The difference between the baseline screening and the evaluation 1 month after high density stimulation, 3 months and 12 months.
    • Subjective sleep quality will be assessed with the Pittsburgh Sleep Quality Index (PSQI).
  • Patient’s satisfaction
    • Time Frame: The difference between the baseline screening and the evaluation 1 month after high density stimulation, 3 months and 12 months.
    • Patient’s satisfaction with the stimulation will be assessed with a 5 item Likert scale

Secondary Measures

  • Pain area coverage
    • Time Frame: The difference between the evaluation 1 month after high density stimulation, 3 months and 12 months.
    • The patient has to draw the areas of pain coverage on a body shape figure
  • Paresthesia threshold
    • Time Frame: The difference between the evaluation 1 month after high density stimulation, 3 months and 12 months.
    • Patient indicates the threshold at which he experiences paresthesia
  • HD stim parameters
    • Time Frame: The difference between the evaluation 1 month after high density stimulation, 3 months and 12 months.
    • Questionnaire towards the clinician regarding the ideal high density parameters for this patient
  • Battery efficiency of the neurostimulator
    • Time Frame: The difference between the evaluation 1 month after high density stimulation, 3 months and 12 months.
    • The battery usage will be measured by frequencies to recharge the battery.
  • AdaptiveStim use (in case of Restore Sensor)
    • Time Frame: The difference between the evaluation 1 month after high density stimulation, 3 months and 12 months.
    • Acquire information on activity from the internal diary; amount of times that patients need to fit the ideal parameters themselves
  • MRI need
    • Time Frame: The difference between the baseline screening and the evaluation 1 month after high density stimulation, 3 months and 12 months.
    • Questionnaire regarding the need for MR scans for other medical conditions

Participating in This Clinical Trial

Inclusion Criteria

  • Failed Back Surgery Syndrome patients (FBSS) with insufficient pain reduction with conventional SCS or FBSS patients suitable for SCS – Age > 18 years – Chronic pain as a result of FBSS that exists for at least 6 months with a pain intensity 5 or higher measured on numeric rating scale (NRS) – Patient has been informed of the study procedures and has given written informed consent – Patient willing to comply with study protocol including attending the study visits Exclusion Criteria:

  • Expected inability of patients to receive or properly operate the spinal cord stimulation system – History of coagulation disorders, lupus erythematosus, diabetic neuropathy, rheumatoid arthritis or morbus Bechterew – Active malignancy – Addiction to any of the following drugs, alcohol (5E/day) and/or medication – Evidence of an active disruptive psychiatric disorder or other known condition significant enough to impact perception of pain, compliance to intervention and/or ability to evaluate treatment outcome as determined by investigator – Immune deficiency (HIV positive, immunosuppressiva, etc.) – Life expectancy < 1 year – Local infection or other skin disorder at site of incision – Pregnancy – Other implanted active medical device

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 65 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Universitair Ziekenhuis Brussel
  • Collaborator
    • Medtronic
  • Provider of Information About this Clinical Study
    • Principal Investigator: Moens Maarten, Prof. dr. – Universitair Ziekenhuis Brussel

References

Song Z, Meyerson BA, Linderoth B. High-Frequency (1 kHz) Spinal Cord Stimulation-Is Pulse Shape Crucial for the Efficacy? A Pilot Study. Neuromodulation. 2015 Dec;18(8):714-20. doi: 10.1111/ner.12344. Epub 2015 Sep 6.

Sweet J, Badjatiya A, Tan D, Miller J. Paresthesia-Free High-Density Spinal Cord Stimulation for Postlaminectomy Syndrome in a Prescreened Population: A Prospective Case Series. Neuromodulation. 2016 Apr;19(3):260-7. doi: 10.1111/ner.12357. Epub 2015 Oct 20.

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