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Peer-reviewedCC BYJournal of clinical medicine

Fast-Acting Subperception Spinal Cord Stimulation for Persistent Spinal Pain Syndromes: Real-World Outcomes for up to 3 Years in an “As-Treated” Cohort from a Global Observational Study

  • Clark Metzger1
  • Blake Hammond1
  • Richard Ferro2
  • Jose Paz-Solis3
  • Georgios Kyriakopoulos4
  • Philippe Rigoard5
  • Ashish Gulve6
  • Jose Emilio Llopis7
  • Pablo Andrade8
  • Sarah Love-Jones9
  • Jan Willem Kallewaard10
  • Jan Vesper11
2 more authors
  • Stephen Pyles12
  • Simon Bayerl13
13 affiliations
  1. 1Orthopedic Surgery Department, HCA Florida West Orthopedic Specialists, Pensacola, FL 32514, USA
  2. 2Interventional Pain Management Department, Multidisciplinary Pain Management Services, Okemos, MI 48864, USA
  3. 3Department of Neurosurgery, Hospital Universitario La Paz, 28046 Madrid, Spain
  4. 4Johanniter-Kliniken Hamm, 59063 Hamm, Germany
  5. 5Department of Neuro-Spine and Neuromodulation, Poitiers University Hospital, 86021 Poitiers, France
  6. 6Department of Anesthesiology and Pain Management, James Cook University Hospital, Middlesbrough TS4 3BW, UK
  7. 7Department of Anesthesiology and Pain Management, Hospital de la Ribera, 46600 Valencia, Spain
  8. 8Department of Stereotactic and Functional Neurosurgery, University Hospital Cologne, 50937 Cologne, Germany
  9. 9Department of Anesthesiology and Pain Management, Southmead Hospital, Bristol BS10 5NB, UK
  10. 10Department of Anesthesiology and Pain Management, Rijnstate Hospital, 6815 AD Arnhem, The Netherlands
  11. 11Department of Stereotactic and Functional Neurosurgery, Heinrich Heine University, 40225 Düsseldorf, Germany
  12. 12Interventional Pain Management Department, Florida Pain Clinic, Ocala, FL 34471, USA
  13. 13Department of Neurosurgery, Inter Neuro, 10629 Berlin, Germany
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Abstract

Background/Objectives: Evidence on the effectiveness of spinal cord stimulation using fast-acting subperception therapy (FAST-SCS) in patients with persistent spinal pain syndrome (PSPS) remains limited. We evaluated clinical outcomes of FAST-SCS in patients with PSPS types 1 (i.e., non-surgical back pain) and 2 (i.e., failed back surgery syndrome). Methods: Our global, multicenter, retrospective, observational chart review included all consecutive adults with chronic low back and/or leg pain due to PSPS who received SCS with a multimodal device and reported using FAST-SCS at their latest follow-up. Available data from the patients’ medical files, documented by site personnel per their standard of care, were collected and analyzed. Pain intensity was assessed using the numerical rating scale (NRS); percent pain relief (PPR) was recorded where available. Main outcomes included changes in overall pain (NRS) compared to baseline, proportion of patients with ≥50% reduction in overall pain (NRS), proportion of patients with minimal pain (NRS ≤ 2), and high responder rates (PPR ≥ 80%). Data was analyzed for all PSPS patients at the last follow-up, with preliminary analysis of patients who completed 3-year assessments. Results in PSPS type 1 and 2 patients at the last follow-up are also presented. Results: In total, 424 patients (mean age 61.6 ± 13.5 years; 57% female; 61% PSPS type 2) were included. Mean baseline NRS was 8.0 ± 1.4. At the last follow-up (mean 1.6 ± 1.5 years post-implantation), NRS decreased by 5.3 points to 2.7 ± 2.3 (p < 0.0001), 77% of patients achieved ≥50% reduction in pain, 56% reported minimal pain, and 62% were high responders. Similar improvements were observed in the preliminary analysis of 104 PSPS patients who completed the 3-year follow-up, with ≥5-point reduction in the NRS, 77% responder rate, 60% patients with minimal pain, and 70% high responders. The analysis of PSPS type 1 and 2 populations, adjusted for baseline NRS and follow-up durations, showed comparable outcomes. Conclusions: In this global, observational, “as-treated” cohort, favorable real-world outcomes were observed in PSPS patients using FAST-SCS, supporting its use as an effective treatment option in chronic spinal pain management.

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Cite

BibTeXRIS
BibTeX
@article{metzger2026fastacting,
  title = {{Fast-Acting Subperception Spinal Cord Stimulation for Persistent Spinal Pain Syndromes: Real-World Outcomes for up to 3 Years in an “As-Treated” Cohort from a Global Observational Study}},
  author = {Clark Metzger and Blake Hammond and Richard Ferro and Jose Paz-Solis and Georgios Kyriakopoulos and Philippe Rigoard and Ashish Gulve and Jose Emilio Llopis and Pablo Andrade and Sarah Love-Jones and Jan Willem Kallewaard and Jan Vesper and Stephen Pyles and Simon Bayerl},
  journal = {Journal of clinical medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15197640},
  url = {https://europepmc.org/article/PMC/PMC13666453},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Fast-Acting Subperception Spinal Cord Stimulation for Persistent Spinal Pain Syndromes: Real-World Outcomes for up to 3 Years in an “As-Treated” Cohort from a Global Observational Study
AU  - Clark Metzger
AU  - Blake Hammond
AU  - Richard Ferro
AU  - Jose Paz-Solis
AU  - Georgios Kyriakopoulos
AU  - Philippe Rigoard
AU  - Ashish Gulve
AU  - Jose Emilio Llopis
AU  - Pablo Andrade
AU  - Sarah Love-Jones
AU  - Jan Willem Kallewaard
AU  - Jan Vesper
AU  - Stephen Pyles
AU  - Simon Bayerl
PY  - 2026
DA  - 2026/10/01
JO  - Journal of clinical medicine
DO  - 10.3390/jcm15197640
UR  - https://europepmc.org/article/PMC/PMC13666453
AB  - Background/Objectives: Evidence on the effectiveness of spinal cord stimulation using fast-acting subperception therapy (FAST-SCS) in patients with persistent spinal pain syndrome (PSPS) remains limited. We evaluated clinical outcomes of FAST-SCS in patients with PSPS types 1 (i.e., non-surgical back pain) and 2 (i.e., failed back surgery syndrome). Methods: Our global, multicenter, retrospective, observational chart review included all consecutive adults with chronic low back and/or leg pain due to PSPS who received SCS with a multimodal device and reported using FAST-SCS at their latest follow-up. Available data from the patients’ medical files, documented by site personnel per their standard of care, were collected and analyzed. Pain intensity was assessed using the numerical rating scale (NRS); percent pain relief (PPR) was recorded where available. Main outcomes included changes in overall pain (NRS) compared to baseline, proportion of patients with ≥50% reduction in overall pain (NRS), proportion of patients with minimal pain (NRS ≤ 2), and high responder rates (PPR ≥ 80%). Data was analyzed for all PSPS patients at the last follow-up, with preliminary analysis of patients who completed 3-year assessments. Results in PSPS type 1 and 2 patients at the last follow-up are also presented. Results: In total, 424 patients (mean age 61.6 ± 13.5 years; 57% female; 61% PSPS type 2) were included. Mean baseline NRS was 8.0 ± 1.4. At the last follow-up (mean 1.6 ± 1.5 years post-implantation), NRS decreased by 5.3 points to 2.7 ± 2.3 (p < 0.0001), 77% of patients achieved ≥50% reduction in pain, 56% reported minimal pain, and 62% were high responders. Similar improvements were observed in the preliminary analysis of 104 PSPS patients who completed the 3-year follow-up, with ≥5-point reduction in the NRS, 77% responder rate, 60% patients with minimal pain, and 70% high responders. The analysis of PSPS type 1 and 2 populations, adjusted for baseline NRS and follow-up durations, showed comparable outcomes. Conclusions: In this global, observational, “as-treated” cohort, favorable real-world outcomes were observed in PSPS patients using FAST-SCS, supporting its use as an effective treatment option in chronic spinal pain management.
SN  - 2077-0383
ER  -