Evaluating Spinal Cord Stimulation as a Therapeutic Strategy for Postmastectomy Pain Syndrome: A Retrospective Observational Study

Yun Li; Yang Chen; Guangfu Wei; Shengtao Wang; Tao Sun; Xuli Zhao

doi:10.1016/j.neurom.2024.10.008

Evaluating Spinal Cord Stimulation as a Therapeutic Strategy for Postmastectomy Pain Syndrome: A Retrospective Observational Study

Neuromodulation. 2024 Nov 25:S1094-7159(24)01198-X. doi: 10.1016/j.neurom.2024.10.008. Online ahead of print.

Authors

Yun Li¹, Yang Chen¹, Guangfu Wei¹, Shengtao Wang¹, Tao Sun¹, Xuli Zhao²

Affiliations

¹ Department of Pain Management, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
² Department of Pain Management, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China. Electronic address: dizzyzhaoxl@163.com.

PMID: 39601730
DOI: 10.1016/j.neurom.2024.10.008

Abstract

Background: Postmastectomy pain syndrome (PMPS) is a chronic condition that significantly impacts breast cancer survivors, marked by persistent neuropathic pain that is often unresponsive to conventional therapies. Spinal cord stimulation (SCS) has emerged as a promising intervention for managing this type of pain. This study aimed to assess the clinical efficacy of SCS in managing PMPS and identify patient-specific factors impacting treatment outcomes.

Materials and methods: This retrospective observational study analyzed 78 female patients who underwent SCS implantation between January and October 2023. The efficacy of SCS was assessed by evaluating changes in visual analog scale (VAS) pain scores from baseline to six months after implantation. The influence of factors such as age, body mass index (BMI), prior treatments, and psychologic health on treatment success was explored using binary logistic regression.

Results: Six months after implantation, 61 patients (78.2%) reported significant pain relief, with a decrease in VAS scores by ≥4 points. Statistical analysis revealed several predictors of positive outcomes: younger age (hazard ratio [HR] = 0.882, 95% CI: 0.802-0.970, p = 0.009), lower BMI (HR = 0.659, 95% CI: 0.487-0.891, p = 0.007), and psychologic treatment (HR = 0.015, 95% CI: 0.001-0.377, p = 0.011). Conversely, prior radiotherapy was associated with less favorable outcomes (HR = 2.139, 95% CI: 1.219-5.808, p = 0.029). The receiver operating characteristic curve analysis confirmed the model's accuracy (area under the curve = 0.927).

Conclusions: SCS is an effective treatment for PMPS, with age, BMI, psychologic treatments, and prior radiotherapy being significant predictors of outcomes. Tailoring treatment plans to these factors can potentially enhance pain management for patients with PMPS.

Keywords: Neuropathic pain; pain management; personalized treatment plans; postmastectomy pain syndrome; spinal cord stimulation.