Spinal Cord Stimulation for Persistent Spinal Pain Syndrome Type 1 With Predominant Low Back Pain: A Systematic Review on Holistic Outcome Measurements.

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.