Longitudinal changes in pain catastrophizing and multidimensional health outcomes after passive-recharge burst spinal cord stimulation: a cohort study with follow-up to two years.

Purpose

To evaluate longitudinal changes in pain catastrophizing following spinal cord stimulation (SCS) and to determine whether baseline pain catastrophizing was associated with patient-reported outcomes over two years after implantation.

Methods

A retrospective cohort study using prospectively collected data from 58 patients undergoing SCS implantation. Pain catastrophizing was assessed using the Pain Catastrophizing Scale (PCS), and pain intensity and multidimensional health outcomes were assessed using the Numeric Rating Scale (NRS) and PROMIS-29, respectively. The primary outcome was change in PCS from baseline. Analyses of PCS were restricted to patients with available baseline PCS data (n = 38). PCS was assessed at baseline and at 3, 6, 12, and 24 months after SCS implantation. Changes from baseline were evaluated using paired t-tests. Associations between baseline PCS and post-implant outcomes were assessed using Spearmans rank correlation.

Results

Among the 38 patients with baseline PCS data, mean PCS scores decreased from 24 ± 12 at baseline to 14.0 ± 11 at 24 months (p < 0.001), with reductions across all three PCS subgroups. Physical function, pain interference, pain intensity, fatigue, anxiety, depression, and participation in social roles also improved significantly during follow-up, whereas sleep disturbance showed no significant change. Baseline PCS was not correlated with most post-implant PROMIS-29 domains.

Conclusion

PCS decreased substantially and persistently following SCS implantation among patients with available baseline PCS data. Baseline PCS was not significantly associated with subsequent pain response or most patient-reported outcomes. PCS may represent a dynamic outcome measure that complements conventional pain-intensity assessment.