In painful peripheral neuropathy-affected people, spinal cord stimulation offers clinically meaningful pain relief.

The objective of a systematic review with narrative synthesis was to assess the effectiveness of spinal cord stimulation (SCS) in relieving pain associated with peripheral neuropathies in the lower limbs and/or lower extremities.

To identify relevant peer-reviewed studies involving peripheral neuropathy subjects experiencing pain in their lower limbs and/or lower extremities, the researchers conducted a thorough search of the PubMed database. Utilizing the Cochrane risk of bias tool, the evidence quality of randomized controlled trials (RCTs) was evaluated. The findings were organized into tables and presented in a descriptive manner.

A total of 20 studies were identified that investigated the use of SCS for treating peripheral neuropathy patients. The studies encompassed various SCS modalities, along with 10 kHz SCS, burst SCS, traditional low-frequency SCS (t-SCS), and dorsal root ganglion stimulation (DRGS). Among the 451 volunteers who got a permanent implant, 267 underwent 10 kHz SCS, 147 received t-SCS, 25 underwent DRGS, and 12 received burst SCS. The majority of the implanted individuals (around 88%) experienced painful diabetic neuropathy (PDN).

All SCS modalities demonstrated clinically significant pain relief (≥30%). RCTs provided support for the utilization of 10 kHz SCS and t-SCS in treating PDN, with 10 kHz SCS yielding a higher decline in pain (76%) compared to t-SCS (38-55%). Pain mitigation with 10 kHz SCS and DRGS for other causes of peripheral neuropathy was noted to range from 42% to 81%. Furthermore, 66-71% of PDN subjects and 38% of non-diabetic peripheral neuropathy individuals experienced neurological betterment with 10 kHz SCS.

SCS treatment provided significant pain relief in peripheral neuropathy patients. RCTs supported 10 kHz SCS and t-SCS utilization for diabetic neuropathy, with better results for 10 kHz SCS. Positive outcomes were observed for 10 kHz SCS in other painful peripheral neuropathy etiologies. Neurological improvement was seen in most PDN patients and a notable subset of nondiabetic peripheral neuropathy subjects with 10 kHz SCS.