Background

Spinal cord stimulation continues to gain increasing popularity in the pain management field for the treatment of different painful conditions, however to-date, the correlation between the spinal cord stimulator effectiveness and biological sex has not been fully established. We aim to investigate the correlation between the biological sex and spinal cord stimulation (SCS) outcomes.

Methods

Following Institutional Review Board approval, a retrospective cohort study was performed by collecting data for patients treated with SCS at a tertiary academic center between the years 2002 and 2019. We used multivariable linear regression model to assess the association between biological sex and pain scores at baseline, 6 and 12-months following SCS implantation. Propensity score matching (PSM) was performed based on a set of covariates including: age, duration of pain, time since implant, BMI, opioid medications use, smoking, depression and history of alcohol or substance abuse.

Results

Of the patients treated with SCS implants, 418 patients fit the inclusion and exclusion criteria, out of which the majority were females (272, 65 %). The pre-matching data reported a significant difference in history of diabetes and depression and was also significant for more opioid use in male patients at baseline and 6-months and 12-months post-SCS implant. Propensity score matching (PSM) was performed based on the above mentioned covariant. After matching, no statistical difference was found among the variables, in both groups. Furthermore, there were no significant differences in outcome measures, i.e., pain scores at baseline and 6- and 12-months post-implant, in both groups after matching.

Conclusion

No sex-based differences in the analgesic response to SCS therapy was detected at 6 and 12 months post-implant between groups with similar demographics, biomedical and psychological values.