Systematic Review to Identify Patient-Level Predictors of Treatment Response to Spinal Cord Stimulation for Neuropathic Pain for Studies Published From 2012 to 2024.

IF 3.2 3区医学 Q2 CLINICAL NEUROLOGY

Neuromodulation Pub Date : 2025-05-30 DOI:10.1016/j.neurom.2025.04.004

Anu Kansal, Sue Copley, Rui V Duarte, Fiona C Warren, Rod S Taylor, Sam Eldabe

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引用次数: 0

Abstract

Objective: Chronic neuropathic pain is challenging to manage, but one recommended treatment is spinal cord stimulation (SCS), which may provide pain relief and improvements in physical function and health-related quality of life. Almost half of the patients do not obtain long-term relief, and selection of appropriate patients can be problematic. The objective of this study was to undertake a systematic review of the contemporary evidence base for patient-level predictors for the outcomes from all types of SCS.

Materials and methods: A literature search of MEDLINE, EMBASE, CINAHL, and WikiStim was conducted to identify contemporary SCS studies published from 2012 to 2024. Study selection, data extraction, and risk-of-bias (RoB) assessment using the Quality in Prognosis Studies tool were performed by two independent reviewers.

Results: A total of 40 studies were included in the review; 28 studies (70%) had high RoB; seven (17.5%) had medium RoB, and five (12.5%) had low RoB. We found no strong evidence of an association between the studied patient-level factors and treatment outcomes, with conflicting results for most patient factors. Confidence in the evidence is limited because the quality of the assessed evidence ranged from low to very low, with a high RoB for most of the included studies.

Conclusion: Access to individual patient data and prospective data collection including the use of large real-world registries with full population inclusion is required to identify potential patient-level factors, thus facilitating future patient selection and enhancing treatment outcomes.

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对2012年至2024年发表的研究进行系统评价，以确定神经性疼痛脊髓刺激治疗反应的患者水平预测因素。

目的：慢性神经性疼痛难以控制，但一种推荐的治疗方法是脊髓刺激（SCS），它可以缓解疼痛，改善身体功能和健康相关的生活质量。几乎一半的患者没有得到长期的缓解，选择合适的患者可能是有问题的。本研究的目的是对所有类型SCS结果的患者水平预测因子的当代证据基础进行系统回顾。材料和方法：检索MEDLINE， EMBASE， CINAHL和WikiStim的文献，确定2012年至2024年发表的当代SCS研究。研究选择、数据提取和使用预后质量研究工具进行的偏倚风险（RoB）评估由两名独立审稿人完成。结果：共纳入40项研究；高罗伯28例（70%）；中度RoB 7例（17.5%），低RoB 5例（12.5%）。我们没有发现强有力的证据表明所研究的患者水平因素与治疗结果之间存在关联，大多数患者因素的结果相互矛盾。证据的可信度有限，因为评估证据的质量从低到极低不等，大多数纳入的研究的RoB都很高。结论：需要获得个体患者数据和前瞻性数据收集，包括使用大型真实世界登记中心，充分纳入人群，以确定潜在的患者水平因素，从而促进未来患者选择并提高治疗效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuromodulation 医学-临床神经学

CiteScore

6.40

自引率

3.60%

发文量

978

审稿时长

54 days

期刊介绍： Neuromodulation: Technology at the Neural Interface is the preeminent journal in the area of neuromodulation, providing our readership with the state of the art clinical, translational, and basic science research in the field. For clinicians, engineers, scientists and members of the biotechnology industry alike, Neuromodulation provides timely and rigorously peer-reviewed articles on the technology, science, and clinical application of devices that interface with the nervous system to treat disease and improve function.