Document Type

Abstract

Publication Date

2-11-2026

Academic Year

2025-2026

Comments

Presented at the 2026 Scholarly Inquiry (SI) Research Project Symposium.

Abstract

Introduction: For more than 50 years, spinal cord stimulation (SCS) has been effectively employed as a surgical intervention for chronic pain management. Despite its clinical success, up to 40% of patients fail to achieve significant pain relief. Computational models have identified epidural lead positioning and the conus medullaris as potential anatomical targets influencing stimulation efficiency. Given the limited availability of clinical data on potential targets of SCS modulation, this project seeks to investigate these anatomical targets in the clinical setting.

Methods: We conducted a retrospective cohort study involving Epic charts of 105 patients who underwent SCS implantation for chronic pain within the past five years. Collected parameters included cathode stimulation settings and vertebral position, analgesia outcomes, and conus medullaris locations. ANOVA & Kruskal-Wallis tests were used to evaluate statistical relationships between lead and conus positioning and analgesia outcomes.

Results: Our preliminary results (n=33) have identified the pedicle region of T10 as having the highest impact in pain reduction, both under the visual analog scale (VAS, μ=4.08, n=6) and Oswestry disability index (ODI, μ=10.83, n=7). The conus medullaris position with the highest reduction of pain was the upper L1 thoracic body (VAS μ=3.81, n=11).

Conclusions: Based on our results so far, the T10 pedicle area appears to be a promising therapeutic target, and the L1 conus anatomical position (i.e. regular anatomical conus) seems to correlate with the strongest therapeutic stimulation. Despite these conclusions, we still need a larger number of patients to reach statistical significance, and this is precisely the next step in the project.

Additional Files
Ponce_Joao_Poster.pdf (2885 kB)

Language

English

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