Spinal Cord Stimulation for Persistent Spinal Pain Syndrome Type 1 With Predominant Low Back Pain: A Systematic Review on Holistic Outcome Measurements
In brief
Spinal cord stimulation improves function, quality of life and cuts meds
A review of five randomized trials found that spinal cord stimulation markedly enhanced functional ability, overall quality of life, and patient satisfaction while reducing reliance on pain medication in people with chronic nonsurgical low back pain. Minor to moderate adverse events occurred in up to one-third of patients, with serious complications being rare. The therapy appears viable for carefully selected, refractory cases.
- Journal
- Neuromodulation : journal of the International Neuromodulation Society (Q1)
- Published
- 15 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Laurens Peene, Adnan Al-Kaisy, Jan Van Zundert, Tom Yearwood, Rui Duarte, Maarten Moens, et al.
- PMID
- 42578901
- DOI
- 10.1016/j.neurom.2026.07.002
Why clinicians should know about it
- Picked for Anesthesiology and Pain Medicine (top studies of the week, 16 August 2026): Spinal cord stimulation for chronic low back pain systematic review
Abstract
BACKGROUND: Chronic nonsurgical low back pain, or persistent spinal pain syndrome type 1 (PSPS-T1) with predominant axial pain, remains an important burden on patient quality of life, with significant economic consequences. The outcome of conservative treatments or surgery in chronic low back pain is often unsatisfactory, and spinal cord stimulation (SCS) has emerged as a promising treatment in this patient population, with multiple randomized trials published in the past decade. Outcome synthesis has primarily been focused on pain relief. MATERIALS AND METHODS: Randomized controlled trials (RCTs) published in the English language, between January 1, 1990 and December 31, 2025 evaluating the effectiveness of SCS in patients with PSPS-T1 with predominant low back pain were identified in MEDLINE, Limo LIBIS, and Cochrane data bases. Objective outcome parameters including quality of life, functionality, perceived effect, patient satisfaction, pain medication usage, and adverse events were collected. RESULTS: Five RCTs met the inclusion criteria. SCS significantly improves functionality, quality of life, and patient satisfaction and significantly reduced pain medication usage in patients with chronic nonsurgical low back pain. Adverse events were reported in 8% to 29% of patients, with most classified as minor or moderate. Severe adverse events, causing explantation, only occurred in a minority of patients. CONCLUSION: SCS significantly improves holistic outcomes parameters in patients with PSPS-T1 with predominant low back pain and can therefore be considered in well-selected patients with refractory pain unresponsive to conventional management. A multidisciplinary approach remains key in this patient group.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.