Cochrane · systematic review · CD013756
Implanted spinal neuromodulation interventions for chronic pain in adults
O'Connell, NE, Ferraro, MC, Gibson, W, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
Pain, Palliative and Supportive CareAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
27
current version
GRADE rated
11
No studies
16
Included studies
NR
No studies 16 · 59.3%Ungraded 0 · 0%Very low 8 · 29.6%Low 3 · 11.1%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Active stimulation vs placebo (sham)
Population: adults with chronic pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain intensity continuous outcomes. (VAS 0 ‐ 100) Active stimulation vs placebo (sham) | no estimate extracted | 6 studies · 164 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Pain intensity. Proportion with ≥ 50% pain relief. Active stimulation vs placebo (sham) | no estimate extracted | NR | No studies |
Adverse event: lead failure/ displacement Active stimulation vs placebo (sham) | no estimate extracted | NR | No studies |
Adverse events: infection Active stimulation vs placebo (sham) | no estimate extracted | NR | No studies |
Adverse events: need for reoperation/ reimplantation Active stimulation vs placebo (sham) | no estimate extracted | NR | No studies |
Adverse events: other Active stimulation vs placebo (sham) | no estimate extracted | NR | No studies |
Pain intensity, continuous outcomes(VAS 0 ‐ 100) Active stimulation vs placebo (sham) | no estimate extracted | NR | No studies |
Pain intensity. Proportion with ≥50% pain relief. Active stimulation vs placebo (sham) | no estimate extracted | NR | No studies |
Adverse events: Infection Active stimulation vs placebo (sham) | no estimate extracted | NR | No studies |
Adverse events: Lead failure/ displacement Active stimulation vs placebo (sham) | no estimate extracted | NR | No studies |
Adverse events: Need for reoperation/ reimplantation Active stimulation vs placebo (sham) | no estimate extracted | NR | No studies |
Pain intensity, continuous outcomes (VAS 0 ‐ 100) Active stimulation vs placebo (sham) | no estimate extracted | NR | No studies |
Adverse events: Need for reoperation/reimplantation Active stimulation vs placebo (sham) | no estimate extracted | NR | No studies |
Active stimulation + other intervention vs other intervention alone
Population: adults with chronic pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain intensity continuous outcomes. (VAS 0‐100, higher scores = worse pain) Active stimulation + other intervention vs other intervention alone | no estimate extracted | 3 studies · 303 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Pain intensity. Proportion with ≥ 50% pain relief. Active stimulation + other intervention vs other intervention alone | RR 15.9 [6.7, 37.74] | 2 studies · 249 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Adverse event: lead failure/ displacement Active stimulation + other intervention vs other intervention alone | no estimate extracted | NR | No studies |
Adverse events: infection Active stimulation + other intervention vs other intervention alone | no estimate extracted | NR | No studies |
Adverse events: need for reoperation/ reimplantation Active stimulation + other intervention vs other intervention alone | no estimate extracted | NR | No studies |
Adverse events: other Active stimulation + other intervention vs other intervention alone | no estimate extracted | NR | No studies |
Pain intensity, continuous outcomes (VAS 0 ‐ 100, higher scores = worse pain) Active stimulation + other intervention vs other intervention alone | no estimate extracted | 5 studies · 635 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Pain intensity. Proportion with ≥50% pain relief. Active stimulation + other intervention vs other intervention alone | RR 7.08 [3.4, 14.71] | 5 studies · 597 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Adverse events:lead failure/ displacement Active stimulation + other intervention vs other intervention alone | RR 3.02 [0.52, 17.58] | 3 studies · 330 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Adverse events:infection Active stimulation + other intervention vs other intervention alone | RR 4.83 [1.09, 21.4] | 4 studies · 548 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Pain intensity, continuous outcomes (VAS 0 ‐ 100, higher scores = worse pain) (5 years Active stimulation + other intervention vs other intervention alone | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Pain intensity. Proportion with ≥ 50% pain relief. (2‐year Active stimulation + other intervention vs other intervention alone | RR 15.15 [2.11, 108.91] | 1 study · 87 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Adverse events: lead failure/ displacement Active stimulation + other intervention vs other intervention alone | RR 15.31 [0.99, 237.16] | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Adverse events: need for reoperation/reimplantation Active stimulation + other intervention vs other intervention alone | RR 25.81 [1.69, 393.31] | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |