Closed-loop spinal cord stimulation (SCS) utilizes evoked compound action potential (ECAP) feedback to maintain constant neural recruitment. This case series reports outcomes from two patients treated with ECAP-controlled closed-loop SCS and evaluate changes in pain intensity and functional status. Two male patients presented with chronic lumbar radiculopathy and axial low back pain. At baseline, the patients reported severe pain with Numeric Rating Scale (NRS) scores of 7-8/10, accompanied by impaired sleep, standing tolerance, and walking capacity. Both patients underwent ECAP-controlled closed-loop SCS trials, during which real-time physiologic feedback was used to automatically adjust stimulation parameters and maintain consistent neural activation. Following treatment, both patients experienced substantial reductions in pain (NRS 1-2/10) along with marked improvements in sleep, standing, and walking tolerance. These improvements remained stable despite positional changes. ECAP-controlled closed-loop SCS was associated with significant improvements in functional outcomes while reducing the need for reprogramming and reintervention.
Soin et al. (Wed,) studied this question.