ID: 214925 Early Experience With Closed-Loop SCS During In-Clinic Testing

Abstract

Therapeutic outcomes with spinal cord stimulation (SCS) have continued to improve with the introduction of new waveforms.1 However, regardless of the waveform in use, the therapy dose delivered to the cord will vary dynamically due to the movement of the cord within the spinal canal, relative to the SCS lead. This leads to the activation of different volumes of tissue and inconsistent therapy delivery. Patients typically respond by adjusting the therapy amplitude up or down, which could result in less-than-optimal pain relief.2 Closed-Loop SCS, titrated by the physiologic response of the spinal cord to stimulation – known as evoked compound action potential (ECAPs), can be used to effectively mitigate this issue and maintain a consistent therapeutic dose.3 The objective of this study is to optimize a workflow to efficiently program Closed-Loop SCS with contemporary waveforms (e.g., Differential Target Multiplexed (DTM) SCS), with an investigational external neurostimulator (ENS), capable of stimulating and recording ECAPs, in Medtronic SCS trial participants.