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Prospective, Two-part Study of the Interaction Between Spinal Cord Stimulation and Peripheral Nerve Field Stimulation in Patients with Low Back Pain: Development of a New Spinal-Peripheral Neurostimulation Method


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  • Conflict of Interest: The authors reported no conflicts of interest.

J. Kelby Hutcheson, MD, Carolinas Center for Advanced Management of Pain, 220 Roper Mountain Road Ext, Greenville, SC 29615, USA. Email:


Objective:  The goal of the study was to assess the efficacy of interaction between spinal cord stimulation (SCS) and peripheral nerve field stimulation (PNFS) and to evaluate a new spinal-peripheral neuromodulation method for low back pain.

Materials and Methods:  The prospective two-part study included patients with low back pain due to failed back surgery syndrome and/or spinal stenosis. In the first part 20 patients were implanted with SCS and PNFS. They selected the best program out of three: SCS alone, PNFS alone, or both together. In the second part another 20 patients with the same implanted leads were selecting between three programs: SCS and PNFS separately, SCS as anode and PNFS as cathode, or in reverse.

Results:  In the first part 79% of the patients selected simultaneous use of SCS and PNFS. The overall success of the trials was 85%. In the second part communication between SCS and PNFS provided wider coverage of axial pain. The overall success of the trials was 90%.

Conclusion:  Simultaneous use of SCS and PNFS increase efficacy of both methods for axial back pain. The new SPN method showed great potential in providing coverage for back pain.

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