title: BMI as a Predictor of Spinal Cord Stimulation Success in Chronic Pain Patients.
abstract: BACKGROUND
  Spinal cord stimulation (SCS) is an effective method of treating chronic pain. Obese patients are overrepresented in chronic pain cases. We examine the effect of body mass index (BMI) on SCS success.
  
  
  METHODS
  We prospectively follow outcome measures including visual analog score, Beck Depression Inventory (BDI), McGill Pain Questionnaire, Oswestry Disability Index (ODI), Pain Catastrophizing Scale (PCS), and the Insomnia Severity Index at baseline, six months, and one year postoperatively. Retrospectively, we examined whether our patients with a BMI above the 75th percentile (BMI ≥36.5) had worse outcomes.
  
  
  RESULTS
  Our analysis included thoracic and cervical SCS patients-19 with a BMI ≥36.5 and 58 with a BMI <36.5. High BMI patients experienced less BDI improvement at 6 months (T(df) 2.257(36); p = 0.030; 95% CI [4.7%, 87.4%]) and one year (2.74(28); p = 0.011; 95% CI [18.1%, 125.0%]) post-SCS. High BMI patients had less improvement in pain as measured by the PCS at one year (U = 79.5; p = 0.045; 95% CI [-116.0%, 0.0%]).
  
  
  CONCLUSIONS
  Each group experienced successful surgical outcomes. High BMI patients had less BDI improvement at six months and one year and less PCS improvement at one year. These data aid us in counseling our patients preoperatively.
authors: Department of Neurosurgery, Albany Medical Center, Albany, NY, USA.|Department of Neuroscience and Experimental Therapeutics, Albany Medical Center, Albany, NY, USA.
authors: Olivia
authors: O
authors: Marola
authors: Department of Neurosurgery, Albany Medical Center, Albany, NY, USA.
authors: Rasan
authors: R
authors: Cherala
authors: Department of Neurosurgery, Albany Medical Center, Albany, NY, USA.
authors: Julia
authors: J
authors: Prusik
authors: Department of Neurosurgery, Albany Medical Center, Albany, NY, USA.
authors: Vignessh
authors: V
authors: Kumar
authors: Department of Neurosurgery, Albany Medical Center, Albany, NY, USA.
authors: Chris
authors: C
authors: Fama
authors: Department of Neurosurgery, Albany Medical Center, Albany, NY, USA.
authors: Meghan
authors: M
authors: Wilock
authors: Department of Neurosurgery, Albany Medical Center, Albany, NY, USA.
authors: Jordan
authors: J
authors: Crimmins
authors: Department of Neurosurgery, Albany Medical Center, Albany, NY, USA.|Department of Neuroscience and Experimental Therapeutics, Albany Medical Center, Albany, NY, USA.
authors: Julie G
authors: JG
authors: Pilitsis
mesh_terms: D000328:Adult; D015992:Body Mass Index; D058443:Catastrophization / Q000628:therapy; D059350:Chronic Pain / Q000150:complications / Q000523:psychology / Q000628:therapy*; D003863:Depression / Q000209:etiology / Q000628:therapy; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D062187:Spinal Cord Stimulation / Q000379:methods*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D064232:Visual Analog Scale; D055815:Young Adult
keywords: Body mass index; chronic pain; depression; pain catastrophizing; spinal cord stimulation