Restorative neurostimulation for refractory low back pain: A durable solution

Restorative neurostimulation of the lumbar multifidus muscles is a safe, efficient, and long-lasting treatment for people with severe, chronic low back pain due to multifidus muscle dysfunction.

Adults suffering from severe, persistent low back pain due to dysfunctional lumbar multifidus muscles often face limited long-term treatment options. A prospective study tested whether restorative neurostimulation could provide substantial, enduring benefits.

In a five-year follow-up of the ReActiv8-B trial, 204 participants with severe, refractory low back pain and impaired multifidus muscle control were treated with neurostimulation. Pain intensity, disability, and quality of life were measured via visual analog scale (VAS), the Oswestry Disability Index (ODI), and the European Quality of Life 5 Dimensions 5 Level Version (EQ-5D-5L) index, respectively.

After five years, pain intensity dropped from 7.3 to 2.4 cm on the VAS, with 71.8% of participants experiencing at least a 50% reduction. Disability improved from 39.1 to 16.5 points on the Oswestry Index, with 61.1% showing a reduction of 20 points or more. Quality of life scores increased from 0.585 to 0.807. Notably, 46% of opioid users at baseline had stopped using opioids, and 23% reduced their intake. The safety profile was favorable, with no lead migrations observed.

Over five years, restorative neurostimulation demonstrated significant, durable improvements in pain, disability, and quality of life, with a promising safety profile for treating refractory chronic low back pain due to multifidus muscle dysfunction.