A closed-loop spinal cord stimulation (SCS) system for the treatment of chronic pain (Evoke ECAP-Controlled, Closed-Loop Spinal Cord Stimulation System; Saluda Medica, Artarmon, Australia) has been launched in Europe. The first commercial use of the system took place in The Netherlands.
The system measures spinal cord response to stimulation via evoked compound action potentials (eCAPs) and adjusts every pulse to optimize activation within the patient's therapeutic window.
The Avalon study (NCT02924129), a prospective, randomized trial with 134 participants, showed that the system maintains long-term results through ECAP control.
"For the first time we can directly measure each individual patient's neurophysiologic response to SCS and use this objective data to guide how we program the system to best treat their individual pain complaint,” said Harold Nijhuis, anesthesiologist and pain management consultant, St. Antonius Hospital. “This is a disruptive advance in the field of neuromodulation that will benefit a huge number of patients suffering with refractory pain conditions. Without the ability to measure, we cannot overcome the variability of spinal cord activation. With Evoke SCS, we can set each patient's individual therapeutic window and let the device adjust on every pulse, millions of times per day, to meet their need."
Claire Smyth, BSc; David Roberts, BSc; and Kenneth Monaghan, PhD
Jennifer Robblee, MD, MSc; Amaal J. Starling, MD; Rashmi B. Halker Singh, MD, FAHS, FAAN; and Nina Riggins, MD, PhD
Allie Massaro, MD