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Clinical Evidence Search

Ilfeld 2021: Pilot RCT of PNS for Postoperative Pain
Summary
  • Multicenter RCT: 66 patients randomized to active PNS vs. sham.
  • PNS was significantly lower vs sham (p<0.001) in the first 7 days after surgery.
  • Interference of pain with emotional and physical functioning was reduced with PNS.
Deer 2021: Percutaneous PNS in Back Pain after Lumbar RFA
Summary
  • Prospective multicenter substudy exploring use of PNS as treatment for chronic back pain after RFA
  • Majority had clinically significant improvements in pain (≥50%)  or functional outcomes, n=15
  • 5 months after start of PNS, 93% reported clinically meaningful improvement in one or more outcomes
Staats 2021: Surveys of Patient Preference for LBP Interventions
Summary
  • Study using two market research surveys of chronic pain patient preferences for LBP interventions.
  • LBP patients preferred temporary interventions to permanently implanted devices.
  • Temporary PNS was the most preferred treatment option over RFA and permanent implants.
Albright-Trainer 2021: PNS vs SMT in Acute Post-Amputation Pain
Summary
  • RCT compared PNS vs standard medical therapy (SMT) in postoperative period following amputation
  • Greater reductions in pain and opioid use with PNS vs standard care for post-amputation pain (n=16)
  • PNS of sciatic and femoral nerves reduced opioid use and and postsurgical pain at 3 months
Woodbury 2021: Cervical PNS for Occipital Neuralgia Case Report
Summary
  • Novel percutaneous PNS approach targeting C2-3 medial branches for occipital neuralgia
  • Case report of patient with 80% headache pain reduction after 8 weeks of PNS treatment
  • Longitudinal C2-3 approach is less technically challenging than the traditional C1 transverse method
Gilmore 2021: Multicenter Study of PNS in Chronic Low Back Pain
Summary
  • Prospective, multicenter study of percutaneous medial branch PNS for chroic axial low back pain
  • Majority of participants reported significant reductions in pain, disability, and pain interference
  • Percutaneous PNS offers a minimally invasive, promising first-line treatment for chronic axial LBP
Deer 2021: Proposed Mechanism of Action for Percutaneous PNS
Summary
  • Discusses potential mechanisms by which PNS may provide prolonged reductions in pain.
  • Remote selective targeting with PNS may produce robust comfortable sensations in the area of pain.
  • Prolonged pain relief may occur as a reversal of maladaptive cortical plasticity driven by PNS.
Ilfeld 2021: RCT of PNS in Acute Postoperative Pain
Summary
  • Secondary analysis of pilot RCT: brachial plexus and sciatic nerve PNS
  • PNS reduced postoperative pain, pain interference, and opioids in the first week after surgery
  • PNS for acute pain following orthopedic surgery is effective and free of systemic side effects
Gilmore 2020: 1 Year Sustained Relief with PNS in Low Back Pain
Summary
  • Case series of Percutaneous PNS of Lumbar Medial Branches for axial back pain
  • Majority had clinically substantial (≥50%) pain relief at end of treatment compared to baseline, n=9
  • Majority had clinically significant pain and/or disability reductions at 12 months after PNS, n=6
Gilmore 2020: PNS in Post-Amputation Pain RCT 12-mo Follow-Up
Summary
  • Placebo-controlled RCT of PNS for chronic neuropathic pain following lower extremity amputation
  • Majority had substantial reductions in pain 12 months after start of PNS, n=9
  • 60-day PNS can provide significant long-term relief of chronic pain following amputation
Mainkar 2020: Pilot Study in Termporary PNS in Oncologic Pain
Summary
  • Case series (n=12) demonstrates promising peripheral targets for the treatment of oncologic pain
  • Successful PNS targeting spinal nerves, brachial plexus, and peripheral nerves for oncological pain
  • Successful relief in 7 of 12 cases, with several reporting relief beyond lead removal
Gupta 2020: Cadaveric Feasibility of Intercostal PNS Implantation
Summary
  • Cadaveric study assessing ultrasound-guided intercostal PNS implantation
  • 12 stimulators implanted between 5th and 10th ribs bilaterally between intercostal muscles
  • Average lead-to-nerve distance: 2.3 mm (SPR MicroLead) and 1.1 mm (StimRouter)