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Closed-Loop Spinal Cord Stimulation: Revolutionizing Chronic Pain Treatment?

  • Writer: Dr John Hong
    Dr John Hong
  • 4 days ago
  • 2 min read

Updated: 2 days ago

John K. Hong, M.D. | 5/16/2025




Closed-loop spinal cord stimulation (SCS) is revolutionizing the treatment of chronic pain by providing real-time, adaptive therapy that responds to the body's needs. Unlike traditional open-loop systems, which deliver fixed stimulation, closed-loop SCS systems adjust their output based on continuous feedback from the nervous system.WSJ+1PubMed+1MedTech Dive+1Northern Pain Centre+1


What Is Closed-Loop Spinal Cord Stimulation?


Closed-loop SCS is an advanced form of neuromodulation therapy designed to alleviate chronic pain. It involves implanting a device that delivers electrical impulses to the spinal cord, interrupting pain signals before they reach the brain. What sets closed-loop systems apart is their ability to monitor the body's response to stimulation and adjust accordingly, ensuring optimal pain relief.Northern Pain Centre+1Hopkins Medicine+1


How It Works: Real-Time Feedback and Adjustment


Closed-loop SCS systems utilize evoked compound action potentials (ECAPs) to measure the spinal cord's response to stimulation. By analyzing these signals, the device can automatically adjust the intensity of stimulation to maintain therapeutic effectiveness. This real-time feedback loop ensures consistent pain relief, even as the patient's activity level or posture changes.WSJ+16Saluda Medical US+16PubMed Central+16neuromodec.org+10SpringerLink+10Medtronic+10


Advantages Over Open-Loop Systems


Traditional open-loop SCS devices deliver constant stimulation, which may not account for changes in the patient's condition or activity. This can lead to periods of under- or overstimulation, reducing effectiveness and comfort. Closed-loop systems, by contrast, adapt in real-time, maintaining stimulation within a therapeutic window and enhancing overall pain management.Saluda Medical US


Leading Manufacturers: Medtronic and Saluda Medical


Medtronic Inceptivâ„¢

Medtronic's Inceptiv™ is a closed-loop SCS system that senses neural responses and adjusts stimulation 50 times per second. This rapid adjustment helps maintain consistent therapy during various activities, reducing the likelihood of overstimulation. The Inceptiv™ system has received FDA approval and is designed to provide patients with a more responsive and personalized pain management solution.Jpain+12Medtronic+12Medtronic+12


Saluda Medical Evoke®


Saluda Medical's Evoke® system is the first SCS device to use ECAPs for real-time monitoring and adjustment of stimulation. By directly measuring the spinal cord's response, Evoke® ensures that therapy remains within the optimal range for pain relief. Clinical studies have demonstrated the system's effectiveness in providing consistent pain relief and improving quality of life for patients with chronic pain.JAMA Network+8Saluda Medical US+8Saluda Medical US+8


Clinical Evidence: Closed-Loop vs. Open-Loop


Studies have shown that closed-loop SCS systems offer superior outcomes compared to open-loop systems. For instance, a randomized controlled trial published in The Lancet Neurology found that patients using closed-loop SCS experienced greater pain reduction and improved quality of life. Additionally, a 36-month follow-up study confirmed the long-term benefits and durability of closed-loop therapy.MedtronicPubMed


Potential Applications


Closed-loop SCS is primarily used to treat chronic pain conditions, including:U.S. Food and Drug Administration

By providing adaptive and personalized therapy, closed-loop systems offer hope for patients who have not found relief through traditional pain management approaches.


Conclusion


Closed-loop spinal cord stimulation represents a significant advancement in chronic pain management. By continuously monitoring and adjusting therapy in real-time, these systems provide more consistent and effective pain relief. As technology continues to evolve, closed-loop SCS holds the promise of improving the lives of countless individuals suffering from chronic pain.Express Healthcare+5neuromodec.org+5Baptist Health+5


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