Disclosures: Mehul J. Desai, MD, MPH: Abbott (Products/Services: No) (Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received)Avanos (Products/Services: No) (Consultant/Advisory Board, Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received, Speaker/Honoraria includes speakers bureau, symposia, and expert witness)Camber Spine (Products/Services: Yes) (Stockholder/Ownership Interest (excluding diversified mutual funds))SPR (Products/Services: Yes) (Consultant/Advisory Board, Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received, Speaker/Honoraria includes speakers bureau, symposia, and expert witness, Stockholder/Ownership Interest (excluding diversified mutual funds))SynerFuse (Products/Services: No) (Consultant/Advisory Board, Stockholder/Ownership Interest (excluding diversified mutual funds))Virdio (Products/Services: No) (Stockholder/Ownership Interest (excluding diversified mutual funds))

Objective: The goal was to characterize responses to medial branch PNS in a prospective multicenter case series study in patients with chronic axial low back pain recalcitrant to multiple non-surgical treatments.

Design: Prospective, multicenter trialSetting : Pain Management ClinicParticipants : 74

Interventions: Percutaneous peripheral nerve stimulation (PNS) of the lumbar medial branch nerves for up to 60 days.

Main Outcome Measures: Prospectively defined endpoints included assessments of pain intensity, disability, pain interference, health-related quality of life, depression, and patient global impression of change.

Results: Clinically and statistically significant reductions in pain, disability, and pain interference were reported by a majority of participants with percutaneous PNS. Seventy-three percent of participants were successes for the Primary Endpoint, reporting clinically significant (≥30%) reductions in back pain intensity at the end of the 2-month percutaneous PNS treatment (n=74, avg. 58% reduction among responders). While prospective follow up remains ongoing, among those who had already completed the long-term follow up visits, reductions in pain, disability, and pain interference were sustained in a majority of participants following PNS through at least 14 months. Among participants taking opioid analgesic medications at baseline, a majority reported reductions in opioid usage at the end of the 2-month percutaneous PNS treatment and at each long-term follow up visit. Participants also reported significant improvements in health-related quality of life, patient global impression of change, and depression with PNS, demonstrating the potential impact of a 60-day PNS treatment on pain and functional outcomes. There were no serious or unanticipated adverse events.Conclusions: Given the minimally invasive, non-destructive nature of percutaneous PNS and the significant benefits experienced by participants, percutaneous PNS may provide a promising first-line neurostimulation treatment for patients with chronic axial LBP.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/prospective-multicenter-trial-of-percutaneous-medial-branch-peripheral-nerve-stimulation-for-the-treatment-of-chronic-axial-low-back-pain/