Evaluating Comfort and Efficacy: A Comprehensive Analysis of ECAP-Controlled Closed-Loop Spinal Cord Stimulation from Patient Perspectives

Rechargeable implantable generators (r-IPGs) have been used in spinal cord stimulation (SCS) for chronic pain treatment since 2004, offering longer lifespans compared to traditional devices. Closed-loop SCS (CL-SCS) systems, which use neurobiological feedback to regulate spinal cord activation, rely on r-IPGs for power. However, there is limited data on the long-term performance of these devices, including the ease of recharging and potential interruptions during the process. To address these gaps, a study was conducted using a 48-item questionnaire distributed to chronic pain patients with CL-SCS devices. Results from 8 patients indicated that the recharging process was generally considered very easy, with an average charge burden of just over three hours per week. Most patients felt confident managing their neurostimulators, though one patient reported interruptions during recharging. These findings suggest that while CL-SCS systems require more effort compared to conventional devices, they offer greater comfort and fewer issues related to recharging and interruption. This early data highlights the need for larger studies comparing CL-SCS with conventional SCS systems to further evaluate patient convenience and device performance.