Younger age predicts greater effectiveness of spinal cord stimulation for chronic pain



Spinal cord stimulation (SCS) is an accepted surgical treatment for neuropathic pain in failed back syndrome or complex regional pain syndrome. However, even in the best selected surgical cases the predictors of adequate pain control are not well defined. The aim of this study was to identify predictors of outcome in patients who underwent SCS in our center.


We performed a retrospective analysis of our neurosurgical database for patients who underwent SCS over the last 8 years in an attempt to identify factors predictive of outcome.


Forty-one patients underwent implantation of epidural electrodes, 34 patients had a successful stimulation trial and received permanent devices. Nine patients experienced a late failure at a median time of 7.8 months (range, 4.5–19 months) after implantation. Age was significantly associated with outcome. Younger patients had a significantly lower rate of treatment failure, and none of the patients above 65 years had a successful long-term outcome.


Our results suggest that younger age is associated with greater long-term effectiveness of spinal cord stimulation and therefore age may influence the success of SCS therapy with older patients having a greater tendency to failure. Earlier intervention may be beneficial in these chronic pain patients.

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  1. 1.

    Babu R, Hazzard MA, Huang KT, Ugiliweneza B, Patil CG, Boakye M, Lad SP (2013) Outcomes of percutaneous and paddle lead implantation for spinal cord stimulation: a comparative analysis of complications, reoperation rates, and health-care costs. Neuromodulation 16(5):418–426, discussion 426–427

    Article  PubMed  Google Scholar 

  2. 2.

    Barolat G (1999) A Prospective Multicenter Study to Assess the Efficacy of Spinal Cord Stimulation Utilizing a Multi-channel Radio-frequency System for the Treatment of Intractable Low Back and Lower Extremity Pain. Initial Considerations and Methodology. Neuromodulation 2(3):179–183

    CAS  Article  PubMed  Google Scholar 

  3. 3.

    Burchiel KJ, Anderson VC, Brown FD, Fessler RG, Friedman WA, Pelofsky S, Weiner RL, Oakley J, Shatin D (1996) Prospective, multicenter study of spinal cord stimulation for relief of chronic back and extremity pain. Spine 21(23):2786–2794

    CAS  Article  PubMed  Google Scholar 

  4. 4.

    Celestin J, Edwards RR, Jamison RN (2009) Pretreatment psychosocial variables as predictors of outcomes following lumbar surgery and spinal cord stimulation: a systematic review and literature synthesis. Pain Med 10(4):639–653

    Article  PubMed  Google Scholar 

  5. 5.

    De La Cruz P, Fama C, Roth S, Haller J, Wilock M, Lange S, Pilitsis J (2015) Predictors of Spinal Cord Stimulation Success. Neuromodulation. doi:10.1111/ner.12325

    Google Scholar 

  6. 6.

    Edwards RR, Fillingim RB, Ness TJ (2003) Age-related differences in endogenous pain modulation: a comparison of diffuse noxious inhibitory controls in healthy older and younger adults. Pain 101(1–2):155–165

    Article  PubMed  Google Scholar 

  7. 7.

    Farrell M, Gibson S (2007) Age interacts with stimulus frequency in the temporal summation of pain. Pain Med 8(6):514–520

    Article  PubMed  Google Scholar 

  8. 8.

    Frey ME, Manchikanti L, Benyamin RM, Schultz DM, Smith HS, Cohen SP (2009) Spinal cord stimulation for patients with failed back surgery syndrome: a systematic review. Pain Physician 12(2):379–397

    PubMed  Google Scholar 

  9. 9.

    Gureje O, Simon GE, Von Korff M (2001) A cross-national study of the course of persistent pain in primary care. Pain 92(1–2):195–200

    CAS  Article  PubMed  Google Scholar 

  10. 10.

    Kumar K, Taylor RS, Jacques L et al (2007) Spinal cord stimulation versus conventional medical management for neuropathic pain: a multicentre randomised controlled trial in patients with failed back surgery syndrome. Pain 132(1–2):179–188

    Article  PubMed  Google Scholar 

  11. 11.

    Kumar K, Toth C, Nath RK, Laing P (1998) Epidural spinal cord stimulation for treatment of chronic pain--some predictors of success. A 15-year experience. Surg Neurol 50(2):110–120, discussion 120–121

    CAS  Article  PubMed  Google Scholar 

  12. 12.

    Melzack R, Wall PD (1965) Pain mechanisms: a new theory. Science 150(3699):971–979

    CAS  Article  PubMed  Google Scholar 

  13. 13.

    Meyerson BA, Linderoth B (2000) Mechanisms of spinal cord stimulation in neuropathic pain. Neurol Res 22(3):285–292

    CAS  PubMed  Google Scholar 

  14. 14.

    North RB, Kidd DH, Farrokhi F, Piantadosi SA (2005) Spinal cord stimulation versus repeated lumbosacral spine surgery for chronic pain: a randomized, controlled trial. Neurosurgery 56(1):98–106, discussion 106–107

    PubMed  Google Scholar 

  15. 15.

    North RB, Kidd DH, Olin JC, Sieracki JM (2002) Spinal cord stimulation electrode design: prospective, randomized, controlled trial comparing percutaneous and laminectomy electrodes-part I: technical outcomes. Neurosurgery 51(2):381–389, discussion 389–390

    PubMed  Google Scholar 

  16. 16.

    Sindou MP, Mertens P, Bendavid U, García-Larrea L, Mauguière F (2003) Predictive value of somatosensory evoked potentials for long-lasting pain relief after spinal cord stimulation: practical use for patient selection. Neurosurgery 52(6):1374–1383, discussion 1383–1384

    Article  PubMed  Google Scholar 

  17. 17.

    Taylor RS, Desai MJ, Rigoard P, Taylor RJ (2013) Predictors of Pain Relief Following Spinal Cord Stimulation in Chronic Back and Leg Pain and Failed Back Surgery Syndrome: A Systematic Review and Meta-Regression Analysis. Pain Pract. doi:10.1111/papr.12095

    Google Scholar 

  18. 18.

    Turner JA, Hollingworth W, Comstock BA, Deyo RA (2010) Spinal cord stimulation for failed back surgery syndrome: outcomes in a workers’ compensation setting. Pain 148(1):14–25

    Article  PubMed  Google Scholar 

  19. 19.

    Van Eijs F, Smits H, Geurts JW, Kessels AGH, Kemler MA, van Kleef M, Joosten EAJ, Faber CG (2010) Brush-evoked allodynia predicts outcome of spinal cord stimulation in complex regional pain syndrome type 1. Eur J Pain 14(2):164–169

    Article  PubMed  Google Scholar 

  20. 20.

    Wall PD, Sweet WH (1967) Temporary abolition of pain in man. Science 155(3758):108–109

    CAS  Article  PubMed  Google Scholar 

  21. 21.

    Washington LL, Gibson SJ, Helme RD (2000) Age-related differences in the endogenous analgesic response to repeated cold water immersion in human volunteers. Pain 89(1):89–96

    CAS  Article  PubMed  Google Scholar 

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Corresponding author

Correspondence to Mojgan Hodaie.

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No funding was received for this research.

Conflict of interest statement

Dr. Hodaie has received an honorarium grant from Medtronic and research support from St. Jude. All the other authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers' bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Additional information

Ido Strauss and Karim Taha contributed equally to this work.

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Strauss, I., Taha, K., Krishna, V. et al. Younger age predicts greater effectiveness of spinal cord stimulation for chronic pain. Acta Neurochir 158, 999–1003 (2016).

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  • Neuropathic pain
  • Spinal cord stimulation
  • SCS