• Mery Paroli, Olivia Bernini, Giuliano De Carolis, Lara Tollapi, Franca Bondi, Antonella Martini, Alessandro Dario, and Adriana Paolicchi.
• Anesthesiology and Pain Therapy UnitAzienda Ospedaliera Universitaria Pisana, Pisa, Italy.
• Pain Med. 2018 May 1; 19 (5): 1023-1032.

IntroductionIt is acknowledged that the way patients cope with pain may influence treatment outcome. In particular, psychological factors are deemed important when considering patients for suitability for spinal cord stimulation (SCS).ObjectiveThe aim of the study is to observe how pre-implantation psychological characteristics impact the effectiveness of SCS for chronic pain.MethodsThe analysis comprised data from 137 patients who underwent an SCS implant. Screening evaluation included a coping strategies profile (Multidimensional Pain Inventory) and psychiatric disorders (Mini-International Neuropsychiatric Interview). Based on SCS implant outcome collected during follow-up visits, patients were divided into three groups: subjects with long-term pain relief (long-term group), subjects who failed the SCS treatment and decided to explant trial device (trial explanter group [TE]), and those who chose a permanent device (permanent explanter group [PE]).ResultsResults showed that most of the patients who failed with the SCS (TE and PE groups) demonstrated a dysfunctional coping profile and showed a higher presence of psychiatric disorders, which significantly influenced the experience and perception of pain.ConclusionsThe findings of this study support the value of a multidisciplinary screening. Addressing psychological issues before SCS implantation can reduce the failure rate of SCS.

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