Differential target multiplexed spinal cord stimulation for chronic lower back and leg pain

The technology described in this briefing is differential target multiplexed spinal cord stimulation (DTM SCS). It is used for people with chronic, intractable, lower back and leg pain.

The innovative aspects are that it uses multiple stimulation signals targeting 6 different anatomical locations on the spinal cord, designed to provide superior pain relief to conventional spinal cord stimulation.

The intended place in therapy would be as an alternative to traditional spinal cord stimulation in adults with chronic, intractable, lower back and leg pain.

The main points from the evidence summarised in this briefing are from 5 studies (1 randomised controlled trial, 1 prospective feasibility study, 1 case series and 2 case reports) including a total of 87 people who had treatment with DTM SCS. They show that DTM SCS is more effective than traditional spinal cord stimulation.

Key uncertainties around the evidence are that there is only 1 randomised study with a control group and none of the evidence comes from the NHS.

Experts advised that DTM SCS is a minor innovative variation of traditional spinal cord stimulation, which could however, provide pain relief and improvements in quality of life to people. They also noted that few patients with chronic intractable pain currently receive spinal cord stimulation.

The cost of DTM SCS therapy is £18,246 per person (excluding VAT). This includes the cost of an implantable neurostimulator and 2 percutaneous leads but does not include the cost of a trial phase or the procedure costs associated with implantation. The trial phase costs £2,170 and the surgical implantation procedure costs £6,564.