493: Real-world Experience With Multiphase SCS and Remote Management: A Consecutive Case Series

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic neuropathic pain, Neuromodulation (e.g. TMS, TDCS, FUS, SCS, MCS, DBS, vagus nerve stimulation), Digital Health Technologies , Treatment/management

Background and Aims: Post-implant spinal cord stimulation (SCS) management has traditionally relied on episodic, clinic-based visits, limiting visibility into day-to-day therapy use and delaying resolution of patient-reported issues. This can lead to periods of non-optimized stimulation impacting pain control and satisfaction.¹ Recent SCS platforms support remote device management, combining continuous, device-derived remote monitoring with remote programming.² These capabilities enable proactive therapy management and objective, longitudinal tracking of therapy utilization and implant status, creating real-world datasets for benchmarking and surveillance.²,³ However, published evidence describing post-implant utilization patterns and the practical impact of remote management in routine practice remains limited.³

Methods: Following Institutional Review Board (IRB) exemption, de-identified data were extracted from a manufacturer database for consecutive patients implanted with a remote monitoring-capable SCS system at a single US clinic. All patients provided authorization to use their deidentified data for research purposes. Data analyzed included status of SCS implant, SCS therapy utilization, incidence of proactive care (PAC) trigger cases (e.g., low device usage, therapeutic window) and remote programming sessions.

Results: As of analysis, 35 consecutive eligible patients had been implanted with the SCS system at the U.S. clinic. Mean age was 64 (range: 43-88) years and 46% (16/36) were female. Mean implant duration was 465 (range: 35-864) days, 97.1% (34/35) of patients remained implanted, 2.6% (1/35) were explanted, and 100% (34/34) of implanted patients were actively using SCS. Including trial and post-implant, 94.3% (33/35) of patients had ≥1 PAC case (median: 11.0 cases); low device usage and charging compliance were most common. Mean case resolution time was 4.9 hours; 95.0% (703/740) were resolved in ≤24 hours.

Conclusions: Remote monitoring prompted proactive interventions to address issues for nearly all patients, and most cases were addressed within 24 hours. Daily device-derived data enabled objective longitudinal tracking of therapy utilization and implant status, including detection of inactive use patterns and “virtual explants” that may be missed with clinic-only follow-up. Together, these results suggest proactive remote management enables timely, individualized therapy optimization, which may support sustained utilization and reduce explant risk. Findings from this single-center experience are consistent with emerging evidence from a prospective clinical trial and recent retrospective, multicenter real-world studies.⁴⁻⁷

References: 1. Amirdelfan K, Antony A, Levy R, et al. Health-related and economic impacts of clinic visit burdens for spinal cord stimulation patients and caregivers [NANS abstract]. Neuromodulation. 2023;26(4):S122-123.
2. Naidu, Ramana K et al. “A Review of the Prospera Spinal Cord Stimulation System with Multiphase Stimulation and Proactive Care.” Current pain and headache reports vol. 29,1 25. 13 Jan. 2025, doi:10.1007/s11916-024-01318-3.
3. Staats P, Deer TR, Hunter C, et al. Remote Management of Spinal Cord Stimulation Devices for Chronic Pain: Expert Recommendations on Best Practices for Proper Utilization and Future Considerations. Neuromodulation. 2023;26(7):1295-1308. doi:10.1016/j.neurom.2023.07.003.
4. Russo M, Yu J, Amirdelfan K, et al. Prospective, Multicenter Study of an Implantable SCS System With Multiphase Stimulation and Remote Device Management: 12-Month Safety and Effectiveness Results. Poster presented at the American Society of Pain and Neuroscience Annual Meeting; July 10-14, 2024; Miami Beach, FL.
5. Russo M, Yu J, Amirdelfan K, Kapural L, Verrills P. Proactive Automatic Daily Remote Monitoring and Remote Programming Enable Rapid Optimization of SCS: 12-Month Results from a Prospective Multicenter Study. Poster presented at the American Society of Pain and Neuroscience Annual Meeting; July 10-14, 2024; Miami Beach, FL.
6. Pope J, Levy RM, Gilligan C, et al. Real-World Spinal Cord Stimulation Utilization and Implant Status: An Analysis of a Novel, Real-Time, Remote Monitoring Database. Neuromodulation. Published online December 17, 2025. doi:10.1016/j.neurom.2025.11.004.
7. Pope J, Kapural L, Gilligan C, et al. Proactive Remote Monitoring Supports Long-term Optimization of Spinal Cord Stimulation: 18-Month Real-World Results. North American Neuromodulation Society Annual Meeting; January 22-25, 2026; Las Vegas, NV.

Presenting Author: David Rosenfeld MD
Submitting Author: Jacob Hicks

Senior Author: David Rosenfeld MD

IASP 2026 Global Year theme of Neuropathic Pain: Yes

• David Rosenfeld: MD - Alliance Spine and Pain Centers
• Koeun Lim: PhD - BIOTRONIK NRO, INC.
• Andrew Kibler: PhD - BIOTRONIK NRO, INC.
• Jacob Hicks: MS - BIOTRONIK NRO, INC.