A single-center retrospective chart review of percutaneous PNS for treatment of chronic shoulder pain

Genaro J. Gutierrez , Pankaj Mehta , Trey Mouch , Shawn Puri , Jacob R. Caylor , William J. Huffman , Nathan D. Crosby , Joseph W. Boggs
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Abstract

Objective

The present IRB-approved retrospective chart review describes the use of a 60-day PNS treatment for shoulder pain at a single center in 60 total consecutive patients.

Background

Chronic shoulder pain affects an increasing number of patients per year and is especially prevalent in elderly populations. Percutaneous peripheral nerve stimulation (PNS) treatment targeting the nerves of the shoulder has been shown to reduce pain in prospective clinical studies and in analysis of real-world data.

Methods

Data were extracted from the electronic medical records of patients who had previously undergone percutaneous PNS treatment for chronic shoulder pain. Demographic data and treatment characteristics were summarized alongside treatment outcomes.

Results

Overall, 84 % (49/58) of patients reported substantial (≥50 %) pain relief at the end-of-treatment. The records for 2 patients did not include patient-reported percent pain relief. The average indwelling period for leads (i.e., treatment period) was 57 days. Findings on treatment effectiveness were consistent when the patient population was stratified by cause of pain, duration living with pain, and presence of pain-modifying comorbidities. Stimulation paradigms were identified and categorized by the nerve target and stimulation frequency (e.g., motor stimulation, sensory stimulation, or bimodal stimulation).

Conclusions

These results indicate percutaneous PNS is an effective treatment for patients with various shoulder pain histories, and while all stimulation paradigms were effective at reducing pain, patients who received bimodal PNS reported the greatest pain relief. Key limitations of the study included heterogeneous shoulder pain etiologies among patients and sparse availability of long-term follow-up data. These data support existing real-world and prospective clinical evidence on the efficacy of 60-day PNS treatment at treating chronic pain and provide valuable insights into its use in clinical practice.

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经皮 PNS 治疗慢性肩痛的单中心回顾性病历审查
背景慢性肩痛每年影响着越来越多的患者,在老年人群中尤为普遍。在前瞻性临床研究和实际数据分析中,针对肩部神经的经皮外周神经刺激(PNS)治疗已被证明可以减轻疼痛。方法从曾接受过经皮外周神经刺激治疗的慢性肩痛患者的电子病历中提取数据。结果总体而言,84%(49/58)的患者在治疗结束时疼痛得到了明显缓解(≥50%)。2 名患者的记录不包括患者报告的疼痛缓解百分比。导联的平均留置期(即治疗期)为 57 天。根据疼痛原因、疼痛持续时间和是否存在可改变疼痛的合并症对患者进行分层后,治疗效果的研究结果是一致的。结论:这些结果表明,经皮 PNS 对不同肩痛病史的患者都是一种有效的治疗方法,虽然所有刺激模式都能有效减轻疼痛,但接受双模式 PNS 治疗的患者疼痛缓解程度最高。该研究的主要局限性包括:患者肩痛病因各异,长期随访数据稀少。这些数据支持现有的关于 60 天 PNS 治疗慢性疼痛疗效的真实世界和前瞻性临床证据,并为其在临床实践中的应用提供了宝贵的见解。
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