Durable Outcomes and Intervention Avoidance in Low Back Pain Up to 5 Years After Percutaneous 60-Day Peripheral Nerve Stimulation.

Abstract

Introduction: Low back pain (LBP) is a leading cause of disability worldwide, and treatment often necessitates invasive interventions that carry significant risks and economic burdens. While prior studies demonstrated durable benefit following percutaneous 60-day peripheral nerve stimulation (PNS), real-world data are needed to characterize long-term outcomes across routine clinical practice. This survey evaluated the durability of patient-reported improvements among a real-world cohort of patients with LBP who responded to 60-day PNS.

Methods: A cross-sectional follow-up survey was administered to patients who previously responded to 60-day PNS targeting the lumbar medial branch nerves. Outcomes assessed included patient-reported percent pain relief and impression of change in quality of life (QoL), physical function, mood, and sleep. Participants also reported use or avoidance of other LBP treatments or interventions since completing 60-day PNS.

Results: The survey was completed by 602 participants, with follow-up durations ranging from 6 to 68 months. Overall, 79% (475/602) of participants required no radiofrequency ablation (RFA), permanent implant, or surgery following 60-day PNS. Among participants who avoided subsequent interventions, 79% (376/475) reported durable improvements in at least one domain (≥ 50% pain relief and/or clinically meaningful improvement of QoL, physical function, mood, and/or sleep) at follow-up. Among participants without a prior permanent neurostimulator implant, 92% (309/336) of those who sought to avoid permanent implantation succeeded. Among those without prior low back surgery who wanted to avoid it, 95% (353/370) avoided surgery through follow‑up.

Conclusions: These findings suggest that patients with LBP who respond to percutaneous 60-day PNS may experience durable relief, with benefits sustained by some for 5+ years. Participants reported reductions in pain leading to improvements in other health domains, and avoidance of subsequent interventions, including surgery, permanent implants, and/or RFA, through long-term follow-up, highlighting the potential use of percutaneous 60-day PNS as a minimally invasive, short-term treatment capable of producing long-lasting benefits in patients with LBP.