Improved Pain and Function Using Multiphase Spinal Cord Stimulation in a Nonsurgical Spine Patient.

BACKGROUND: Chronic low back pain due to degenerative disc disease (DDD) and lumbar spondylosis is a leading cause of disability. Many patients exhaust conservative and interventional treatments yet remain poor surgical candidates. Spinal cord stimulation may be an effective therapy for many of these patients. CASE PRESENTATION: A 65-year-old female with lumbar DDD and lumbar spondylosis presented with chronic low back pain refractory to conservative therapy. She previously failed acetaminophen, NSAIDs, gabapentinoids, muscle relaxants, and opioids, as well as multiple interventional procedures including epidural steroid injections, medial branch blocks, radiofrequency ablation, and sacroiliac joint injections. The patient underwent an SCS trial using the Biotronik Prospera system with multiphase stimulation, achieving approximately 60% pain relief and marked functional improvement. She subsequently received a permanent SCS implant, reporting >90% sustained pain reduction. She was able to discontinue opioid therapy entirely. At >9-month follow-up, she continued to experience durable benefit, had lost more than 35 pounds, increased physical activity, and returned to independent function. CONCLUSION: This case highlights the effectiveness of SCS as a treatment option for chronic nonsurgical back pain, demonstrating not only substantial pain reduction but also improved function, weight loss, medication reduction, and overall quality of life. Multiphase stimulation with the Biotronik Prospera system may provide an effective alternative for patients who do not respond to comprehensive conservative care.