Comparative outcomes of spinal cord stimulation for neuropathic pain: peripheral nerve versus spinal cord lesions

Abstract Spinal cord stimulation (SCS) is commonly used to treat refractory neuropathic pain. However, no prior study has compared SCS outcomes between neuropathic pain of peripheral nerve origin and neuropathic pain of spinal cord origin. This study aimed to compare SCS outcomes between these two patient groups. Twenty-seven patients with refractory neuropathic pain underwent SCS. Of these, 14 had peripheral nerve lesions, whereas 13 had spinal cord lesions. Demographic data, numeric pain rating scores, and SCS outcomes were collected. These parameters were then compared between the two groups. Patients with neuropathic pain of peripheral nerve origin had more localized pain distribution ( p  = 0.012, OR = 8.33, 95% CI = 1.47‒47.23) than those with spinal cord origin. They also had a higher rate of successful trial stimulation ( p  = 0.018, OR = 9.60, 95% CI = 1.48‒62.16) and better long-term pain relief ( p  = 0.006). The poorest outcomes were observed in those with traumatic spinal cord injury. No complications occurred in this series. Patients harboring neuropathic pain of peripheral nerve origin demonstrated a higher success rate of trial stimulation and superior long-term outcomes following SCS compared with patients who had spinal cord lesions. These findings may aid clinicians in forecasting SCS outcomes and selecting appropriate candidates for the procedure.