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The effect of COVID-19 on pain control in patients with a neurostimulator in situ- a retrospective study

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Abstract

Background

De-novo chronic neuropathic pain following COVID-19 is widely recognised. However, there are currently no published studies investigating the effect of SARS-CoV-2 infection on patients with pre-existing neuropathic pain who have required spinal cord stimulator (SCS) implantation. Here, the authors aimed to analyse outcomes in their institution’s patients who had spinal cord stimulator (SCS) implantation or revision procedures to the system over a 5-year period. Specifically, the short-term and long-term outcomes of patients who contracted COVID-19 during the follow-up period were compared to the control group of patients who did not.

Method

Patients included in this study had spinal cord stimulator implantation (de-novo and revision procedures) between 1 January 2017 and 31 January 2022, for neuropathic pain of any aetiology. Patients deemed eligible for the study were invited to participate in a telephone survey through which clinical outcome data were collected. Pain scores were assessed with a modified form of the Brief Pain Inventory (BPI).

Results

Of 91 patients, 48 (52.7%) had contracted COVID-19 by the time of the survey. Patients who contracted COVID-19 had significantly worse BPI scores in the ‘Least pain’ domain following their infection and at time of the survey, when compared to their score 6 months after the operation. 22.9% (n = 11) of the patients who contracted COVID-19 experienced a change in their symptoms following their infection. Within this sub-group, there was a statistically significant deterioration in BPI scores in 10/11 domains following their infection and in 2/11 domains at time of the survey. Worsening severity of COVID-19 symptoms was not associated with worse BPI scores.

Conclusions

Infection with SARS-CoV-2, in a significant proportion of patients with an SCS in situ, causes at least a transient deterioration in pain control. Further prospective multicentre studies are indicated to establish the prevalence of this phenomenon.

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Data availability

Identifiable patient data has been strictly kept in password protected computers within the Nottingham University Hospitals NHS Trust.

Code availability

Not applicable.

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Funding

This study did not receive any dedicated funding.

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Authors and Affiliations

  1. Department of Neurosurgery, Queen’s Medical Centre, Nottingham University Hospitals NHS Foundation Trust, Nottingham, UK

    Rudrajit Kanjilal, Ananyo Bagchi & Surajit Basu

Authors
  1. Rudrajit Kanjilal
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  2. Ananyo Bagchi
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  3. Surajit Basu
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Contributions

RK performed the literature review, AB performed the data collection and analysis and SB maintained overall supervision of the study and edited the paper prior to submission for publication. RK and AB contributed equally to this paper and should be considered its co-first authors.

Corresponding author

Correspondence to Ananyo Bagchi.

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Ethics approval

Formal approval for this study was obtained from the Nottingham University Hospitals NHS Foundation Trust’s audit and research department.

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Verbal consent was received from all participants prior to participation in the telephone survey.

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All authors are in agreement for this manuscript to be submitted for publication.

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The authors have no conflicts of interest or competing interests to declare.

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This paper was presented at Society of British Neurological Surgeons Conference in London (13th-15th September 2023).

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Kanjilal, R., Bagchi, A. & Basu, S. The effect of COVID-19 on pain control in patients with a neurostimulator in situ- a retrospective study. Acta Neurochir 166, 175 (2024). https://doi.org/10.1007/s00701-024-06014-0

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