A study from the Cleveland Clinic reported a 20% better pain response to spinal cord stimulation therapy among patients categorized as underweight/normal than morbidly obese.
Investigators used self-reported data from 181 patients treated with spinal cord stimulation (SCS) implants to determine the relationship between body mass index (BMI) and pain relief (Spine J 2019;:476-486). Categorized into four groups, the researchers found a 2% reduction in efficacy for every BMI unit.
The investigators measured pain on an 11-point numerical rating scale before and at six and 12 months after SCS implantation. Using multivariable regression analysis and adjusting for confounding factors such as opioid utilization, they found an inverse relationship between post-SCS outcomes and BMI.
“It could be that being overweight is associated with other degenerative conditions, such as osteoarthritis, that can exacerbate pain in ways that are not amenable to SCS treatment, or that other medical conditions that are more common in people with higher BMI lead to a loss of pain relief over time,” said Joshua M. Rosenow, MD, FAANS, FACS, the director of functional neurosurgery and epilepsy surgery at Northwestern Medicine, in Chicago.
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