Understanding the Role of Patient Preference in the Treatment Algorithm for Chronic Low Back Pain: Results from a Survey-Based Study

Figures & data

Figure 1. Treatment options by order of choice as ranked by Survey 1 respondents.

PNS: Peripheral nerve stimulation; SCS/DRG: Spinal cord stimulation/dorsal root ganglion stimulation.

Figure 2. Mean rank values by treatment option.

*p = 0.0008 versus permanently implanted PNS. ^∧p ≤ 0.0001 versus permanently implanted SCS/DRGS.

PNS: Peripheral nerve stimulation; SCS/DRG: Spinal cord stimulation/dorsal root ganglion stimulation; SEM: Standard error of the mean.

Table 1. Treatment preferences among patients with lower back pain before and after follow-on details about temporary PNS and RFA.

	Before		After
Temporary peripheral nerve stimulation	46	47.9%	52	54.2%
Radiofrequency ablation	50	52.1%	38	39.6%
Permanently implanted system	NA^†	NA^†	6	6.3%

† follow-on details were only provided to subjects that chose temporary peripheral nerve stimulation or radiofrequency ablation as their most desired option initially.

NA: Not applicable; PNS: Peripheral nerve stimulation; RFA: Radiofrequency ablation.

Table 2. Treatment preferences after follow-on details.

	Continued with first choice	Switched to temporary PNS vs. RFA	Switched to permanently implanted system
Temporary PNS	80.4% (n = 37)	17.4% (n = 8)	2.2% (n = 1)
RFA	60% (n = 30)	30% (n = 15)	10% (n = 5)

PNS: Peripheral nerve stimulation; RFA: Radiofrequency ablation.

Table 3. Demographic information for survey 2 respondents (n = 347).

Sex
Female	180 (52%)
Male	167 (48%)
Age (years)
18–29	57 (16%)
30–44	91 (26%)
45–60	138 (40%)
>60	61 (18%)
Severity of low back pain
Moderate	243 (70%)
Severe	104 (30%)
Duration of low back pain
<1 year	38 (11%)
1–5 years	127 (37%)
5–10 years	97 (28%)
>10 years	85 (24%)

Figure 3. Initial and final preference choice for temporary peripheral nerve stimulation and radiofrequency ablation/permanent implant.

(A) Initial and final choices of most desired treatment option among low back pain patients in Survey 1, stratified by their initial choice of Temporary PNS or RFA. Final choices reflect changes after additional information was provided about a potential side effect of each treatment option. p = 0.068. (B) Final choices of all low back pain patients who initially chose temporary PNS or RFA.

*p < 0.0001.

PNS: Peripheral nerve stimulation; RFA: Radiofrequency ablation.

Table 4. Treatment preference among respondents with low back pain after follow-on details.

	Continued with first choice	Switched treatment preference	Desired neither
Stimulation	70% (n = 119)	23% (n = 39)	6% (n = 11)
Ablation	50% (n = 58)	34% (n = 40)	16% (n = 19)

Figure 4. Initial and final choice among stimulation, ablation or neither treatment.

(A) Initial and final choices of most desired treatment option among low back pain patients in Survey 2, stratified by their initial choice of stimulation or ablation. Final choices reflect changes after additional information was provided about a potential side effect of each treatment option. (B) Final choices of all low back pain patients who initially chose stimulation or ablation.

*p = 0.0007; **p = 0.0001.