59. The UK&I National Neuromodulation Registry: spinal cord stimulation improves quality of life for patients with visceral pain

Abstract

Background: Spinal cord stimulation (SCS) is a well-established treatment for chronic neuropathic pain and is most commonly used for persistent spinal pain syndrome. Other difficult chronic pain syndromes have also been treated using SCS. There is a paucity of large series and randomized trials assessing the effectiveness of SCS for their treatment. One such indication is severe refractory visceral pain. The National Neuromodulation Registry (NNR) is a UK-wide repository of demographic, diagnostic, device identification, and quality-of-life (QoL) outcome data for patients undergoing SCS. It is governed by the Neuromodulation Society of the UK and Ireland (NSUKI), and operated by an independent third party (NEC Software Solutions UK). Method(s): QoL (EuroQoL 5-dimension 5-level) and demographic data were extracted from the NNR, for patients treated with SCS for visceral pain between February 2018 and July 2023 in 27 UK centres. Those without recorded baseline EQ5D data were excluded. Follow-up timepoints were 6 and 12 months. Result(s): Of the 65 included patients, 36 (55.4%) were female, and 29 (44.6%) were male. The mean age at surgery was 52.4 years (sd=13.4 years). The median EQ5D utility index was significantly higher 6 months after surgery than before (0.535 [n=34] vs. 0.316 [n=65], p=0.002, Wilcoxon rank sum test), and this change was sustained at 12 months after surgery (0.516 [n=29] vs. 0.535 at 6 months [n=34], p=0.76, Wilcoxon rank sum test). The utility index increased by a mean of 0.224 (sd = 0.370 [n=42]). 74.4% of patients improved their EQ5D utility after surgery. Conclusion(s): SCS significantly improves QoL for patients with chronic visceral pain in a prospective multicentre patient cohort. In context, a utility change of +71% after surgery represents a proportionate health utility gain of nearly 6 times that seen with groin hernia repair; greater than that with spinal surgical interventions, and bettered only by joint replacement. Copyright © 2025