title: A Single Center Prospective Observational Study of Outcomes With Tonic Cervical Spinal Cord Stimulation.
abstract: BACKGROUND
  Spinal cord stimulation (SCS) has been a valuable resource for the treatment of chronic, nonmalignant pain that persists in the face of maximal medical management. A recent study demonstrated efficacy of cervical SCS in a multicenter registry. Here, in our single center study, we are able to delve into patient specifics, explore outcomes with percutaneous vs. paddle implants, and examine impact of patient symptomatology.
  
  
  METHODS
  We prospectively collected data on subjects who underwent cervical SCS via numeric rating scale (NRS), McGill Pain Questionnaire, Oswestry Disability Index (ODI), and Beck Depression Inventory. Subjects completed this battery pre-operatively, at six months and at one year. Data were analyzed via repeated measures ANOVA, bivariate correlation analysis, and paired t-tests.
  
  
  RESULTS
  In 30 consecutive subjects, 24 had a complete data set. The diagnosis was failed neck surgery syndrome (13%), Complex regional pain syndrome (29%), and neuropathic pain (58%). Compared with baseline, NRS score significantly improved at six months (p = 0.021) and one year (p = 0.047). ODI score also improved at one year (p = 0.009). At both six months and one year, subjects with percutaneous implants reported significantly less disability on ODI (p = 0.016 and 0.034, respectively), as compared with those who received paddle implants. There was no difference in NRS score or any other outcome measure based on type of implant. Diagnosis or region of pain did not correlate with any measure of outcome.
  
  
  CONCLUSIONS
  We demonstrate that neck and arm pain can be improved with cervical SCS at six month and one-year follow-ups. Both percutaneous and paddle implants have benefit. We tend to place percutaneous implants for radicular pain and retrograde C1-2 paddles for axial pain that is ineffectively treated during the trial.
authors: Department of Neurosurgery, Albany Medical College, Albany, NY, USA.
authors: Sameah
authors: S
authors: Haider
authors: Department of Neurosurgery, Albany Medical College, Albany, NY, USA.
authors: Stephane
authors: S
authors: Owusu-Sarpong
authors: Department of Neurosurgery, Albany Medical College, Albany, NY, USA.
authors: Maria
authors: M
authors: Peris Celda
authors: Department of Neurosurgery, Albany Medical College, Albany, NY, USA.
authors: Meghan
authors: M
authors: Wilock
authors: Department of Neurosurgery, Albany Medical College, Albany, NY, USA.|Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA.
authors: Julia
authors: J
authors: Prusik
authors: Department of Neurosurgery, Albany Medical College, Albany, NY, USA.|Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA.
authors: Youngwon
authors: Y
authors: Youn
authors: Department of Neurosurgery, Albany Medical College, Albany, NY, USA.|Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA.
authors: Julie G
authors: JG
authors: Pilitsis
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000502:physiology*; D059350:Chronic Pain / Q000628:therapy*; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D011446:Prospective Studies; D062187:Spinal Cord Stimulation / Q000379:methods*; D016896:Treatment Outcome
keywords: Anxiety; axial pain; cervical; depression; neck pain; neuropathy; pain; quality of life; spinal cord stimulation