ORIGINAL ARTICLE
Subcutaneous Target Stimulation
(STS) in Chronic Noncancer Pain:
A Nationwide Retrospective Study
Sabine Sator-Katzenschlager, MD*; Katharina Fiala, MD*;
Hans G. Kress, MD, PhD*; Alexandra Kofler, MD
†
; Josef Neuhold, MD
‡
;
Herwig Kloimstein, MD
§
; Wilfried Ilias, MD
¶
; Eva-Maria Mozes-Balla, MD**;
Michaela Pinter, MD
††
; Nadja Loining, MD
†
; Wolfgang Fuchs, MD
§
;
Georg Heinze, PhD
‡‡
; Rudolf Likar, MD
§§
*Department of Special Anesthesia and Pain Therapy, Medical University of Vienna, Vienna,
Austria,
†
Clinical Department of Neurosurgery, Medical University of Innsbruck, Innsbruck,
Austria,
‡
Department of Anaesthesiology, Intensive Care and Pain Therapy, Krankenhaus der
Elisabethinen Graz, Graz, Austria,
§
Department of Anesthesiology and Intensive Care
Medicine, Pain Management Centre, General Hospital Linz, Linz, Austria,
¶
Department of
Anesthesiology, Intensive Care and Pain Therapy, Krankenhaus der Barmherzigen Brüder,
Vienna, **Department of Neurosurgery, Academic Teaching Hospital Feldkirch, Feldkirch,
Austria,
††
Neurological Rehabilitation Centre Rosenhuegel, Vienna,
‡‡
Core Units for Medical
Statistics and Informatics, Medical University of Vienna, Vienna, Austria,
§§
Department of
Anaesthesiology and Intensive Medicine, Interdisciplinary Center of Pain Therapy and
Palliative Medicine, General Hospital Klagenfurt, Klagenfurt, Austria
Abstract: Stimulation of primary afferent neurons offers
a new approach for the control of localized chronic pain. We
describe the results with a new neurostimulation technique,
subcutaneous target stimulation (STS), for the treatment
of chronic focal noncancer pain. STS applies permanent
electrical stimulation directly at the painful area via a
percutaneous-placed subcutaneous lead. We reported the
clinical outcomes of 111 patients with focal chronic, noncan-
cer pain treated with STS in this first nationwide, multicenter
retrospective analysis. The indications for STS were low back
pain (n = 29) and failed back surgery syndrome (back pain
with leg pain) (n = 37), cervical neck pain (n = 15), and pos-
therpetic neuralgia (n = 12). Pain intensity was measured on
a numerical rating scale (NRS) before and after implantation.
Data on analgesic medication, stimulation systems, position,
and type of leads and complications were obtained from the
patients’ records. After implantation, the mean pain inten-
sity improved by more than 50% (mean NRS reduction from
8.2 to 4.0) in the entire patient group (P = 0.0009). This was
accompanied by a sustained reduction in demand for anal-
gesics. In all the patients, the STS leads were positioned
directly at the site of maximum pain. Lead dislocation
occurred in 14 patients (13%), infections in 7 (6%), and in 6
cases (5%), lead fractures were observed. The retrospective
Address correspondence and reprint requests to: Sabine Sator-
Katzenschlager, MD, Department of Special Anesthesia and Pain
Therapy, Medical University of Vienna, AKH Vienna, Waehringer Guertel
18-20, A-1090 Vienna, Austria. E-mail: sabine.sator-katzenschlager@
meduniwien.ac.at.
Submitted: October 3, 2009; Accepted: December 6, 2009
DOI. 10.1111/j.1533-2500.2009.00351.x
© 2010 World Institute of Pain, 1530-7085/10/$15.00
Pain Practice, Volume 10, Issue 4, 2010 279–286