• Philippe Rigoard, Amine Ounajim, Bénédicte Bouche, Maarten Moens, Lisa Goudman, Sam Eldabe, Manuel Roulaud, Bertille Lorgeoux, Sandrine Baron, Kévin Nivole, Mathilde Many, Lucie Lampert, Romain David, and Maxime Billot.
• CHU de Poitiers, Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery Lab, F-86000 Poitiers, France; CHU de Poitiers, Department of Spine Neurosurgery and Neuromodulation, F-86000 Poitiers, France; Université de Poitiers, Prime Institute UPR, CNRS, ISAE-ENSMA, Poitiers, France.
• Neuromodulation. 2025 Feb 1; 28 (2): 283296283-296.

ObjectivesSpinal cord stimulation (SCS) and dorsal root ganglion stimulation (DRGS) have individually shown efficacy in relieving pain in patients with persistent spinal pain syndrome after spinal surgery (PSPS-T2). Combining SCS and DRGS simultaneously, along with Burst stimulation programming, may enhance the responder rate of patients with PSPS-T2.Material And MethodsThis study aimed to compare the pain relief (≥50%) responder rates in SCS, DRGS, and SCS+DGRS (DUAL) through a three-month randomized cross-over trial in patients with PSPS-T2. After the cross-over period, stimulation programming was switched to Burst. Secondary objectives included evaluating the clinical efficacy at three-, four-, six-, and 12-month follow-ups, assessing pain intensity, area of pain, area of paresthesia coverage, quality of life, functional disability, psychologic distress, medication intake, and the Multidimensional Clinical Response Index (MCRI).ResultsThe responder rate of pain relief was similar in SCS, DRGS, and DUAL (60%, p = 0.84) at the end of the cross-over period, increasing to 80% with the ability to switch between stimulation possibilities. Burst programming did not provide additional pain relief at the four-month follow-up (p = 0.99). Clinical outcomes significantly improved until 12-month follow-up compared with baseline. Considering a clinically significant increase of 1.05 of the MCRI, all patients were responders at three-, four-, and six- month follow-up, and 80% were responders at 12 months compared with baseline.ConclusionsThe full option to stimulate different neural structures, separately or simultaneously, led to improved responder rates, allowing patients to personalize treatment. A multidimensional assessment is essential to reveal the full potential benefits of neuromodulation in patients with chronic pain.Copyright © 2024. Published by Elsevier Inc.

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