1284. Spinal Cord Stimulation Induces Weight Loss in Subset of Obese Patients

Authors: Julie G. Pilitsis, MD, PhD, FAANS; Shelby Sabourin; Marisa DiMarzio, BS; Yasaman Alam, BS; Cheyenne Bridger, BS; Maria Hancu (Albany, NY)

Introduction: Obesity effects 39.8% of adults in the U.S. and leads to hypertension and diabetes type 2. Medications and bariatric surgery have limited benefit. Here we examine the effect of spinal cord stimulation (SCS) for chronic pain relief on weight loss. We explore relative role of pain relief on this phenomenon.

Methods: We reviewed our database and found 225 patients that had > 6 month outcomes. Seventy-three with thoracic SCS had pre-operative BMI > 30. Outcomes included: Numeric rating scale score (NRS), Beck Depression inventory (BDI), McGill Pain Questionnaire (MPQ), Oswestry Disability Index (ODI), and Pain Catastrophizing Scale (PCS).

Results: At a mean follow-up of 7.5 months, 12 of the 73 patients (16.44%) experienced greater than 5 percent reduction in their BMI. Patients with weight loss had a significant improvement in MPQ (p=0.03), as compared to those that did not lose weight and a tendency for improvement in ODI (p=0.07) and average pain/NRS (p=0.09)  A subset analysis suggested the possibility that patients receiving subparesthesia stimulation (p = 0.13) may have more weight loss in a large data set.

Conclusion: Our series is one of the first to show weight loss with SCS implanted for pain relief. 16.44 % of our patients had weight loss and patients with weight loss had better pain relief on MPQ. Whether SCS can be optimized for better weight loss needs to be elucidated.