Pain Relief and Opioid Usage in Upper Limb and Neck Pain Patients After 10-kHz Spinal Cord Stimulation Treatment: Subanalysis of USA Studies

Figures & data

Figure 1. Study flow.

Subjects from the SENZA-ULN and SENZA-UEP studies were selected on the basis of available pain scores and opioid dose information at baseline or after 12 months of stimulation. A total of 41 subjects were included in the current analysis.

MME: Milligram morphine equivalent; VAS: Visual analog scale.

Table 1. Baseline demographics and clinical characteristics of subjects from SENZA-ULN and SENZA-UEP included in the analysis.

Characteristics	n = 41
Gender, n (%)
– Female	25 (61%)
– Male	16 (39%)
Age (years) at enrollment
– Median	51
– SD	11.2
– Range	27–70
Diagnosis, n (%) ^†
– Chronic intractable upper limb pain	37 (90%)
– Chronic intractable neck pain	38 (93%)
Upper limb pain, n (%)
– Bilateral	26 (70%)
– Unilateral	11 (30%)
Baseline use of opioids, n (%)
– Average opioid dose	73.9
– Subjects taking >90 MME dose at baseline	10 (24%)
– Average opioid dose in subjects taking >90 MME dose at baseline	158.8
Average VAS (cm) at baseline
– Upper limb pain – Neck pain	7.6 8.1

† Subject could have more than one etiology.

MME: Milligram morphine equivalent; SD: Standard deviation; VAS: Visual analog scale.

Figure 2. Treatment with 10-kHz spinal cord stimulation was associated with pain relief, as shown by visual analog scale scores (A & B) and response and remission rates, (C) and reduced opioid consumption as assessed by daily milligram morphine equivalents (D).

**p < 0.01; ***p < 0.001.

MME: Milligram morphine equivalent; VAS: Visual analog scale.

Figure 3. Change in opioid consumption after 12 months of 10-kHz spinal cord stimulation treatment.

Figure 4. Reduced opioid consumption associated with 10-kHz spinal cord stimulation did not adversely affect pain relief.

Pain scores (A & B); Response and remission rates (C & D) and mean daily opioid dose at baseline and 12 months in subjects who decreased or eliminated opioid consumption (E) and in subjects who did not change or increased their opioid consumption (F).

**p < 0.01; ***p < 0.001.

MME: Milligram morphine equivalent; VAS: Visual analog scale.

Figure 5. Reduced opioid consumption also seen in subjects taking high-risk doses.

Subjects with baseline opioid doses of more than 90 mg morphine equivalents per day reduced their mean opioid consumption after 12 months of treatment with 10 kHz spinal cord stimulations (A) and their pain scores were also reduced (B). A similar reduction in pain scores was observed in the subset of subjects taking high-dose opioids who decreased or eliminated opioid (C).

*p < 0.05; **p < 0.01.

MME: Milligram morphine equivalent; VAS: Visual analog scale.