(135) Short-Term Disability and Pain Outcomes following Spinal Cord Stimulator Implant in Patients with Comorbid Psychiatric Illness at 3- and 6-Month Follow-Up

Spinal cord stimulators (SCSs) have been shown to reduce pain and improve function in patients with chronic pain. Chronic pain is highly co-morbid with mental health conditions (MHCs). However, there is minimal research examining this comorbidity and SCS outcomes within the military health care system (MHS). This quality improvement project looks at short-term outcomes post SCS implant in patients with comorbid psychiatric diagnoses. The Walter Reed National Military Medical Center (WRNMMC) SCS Cohort includes active duty service members, veterans, and dependents who underwent implantation. Most received a psychological rating (PR) assessing readiness to proceed (higher ratings suggests a need to engage in behavioral-health treatment concurrently with/or prior to implantation); the patients filled out questionnaires that assessed past psychiatric diagnoses, pain disability, and pain numerical rating scale (NRS) at 3- (N= 128) and 6-months (N=92); and patients’ self-report of satisfaction with SCSs at 3- and 6-months. The majority of patients were male, active duty, and had noncombat-related injuries. The mean age was 45 years. Linear regressions suggest that patients with MHC have worse pain disability outcomes at 3-months. A linear regression suggests that higher PRs predict higher pain NRS ratings and worse pain disability outcomes at 3-months. Linear regression suggests that lower PRs predict higher patients’ self-reported satisfaction with SCSs at 6-months. This project suggests that it is important for providers working in the MHS to assess patients’ co-morbid MHCs prior to implementation since these factors appear to impact pain disability ratings, NRS, and patients’ self-reported satisfaction with implantation. Spinal cord stimulators (SCSs) have been shown to reduce pain and improve function in patients with chronic pain. Chronic pain is highly co-morbid with mental health conditions (MHCs). However, there is minimal research examining this comorbidity and SCS outcomes within the military health care system (MHS). This quality improvement project looks at short-term outcomes post SCS implant in patients with comorbid psychiatric diagnoses. The Walter Reed National Military Medical Center (WRNMMC) SCS Cohort includes active duty service members, veterans, and dependents who underwent implantation. Most received a psychological rating (PR) assessing readiness to proceed (higher ratings suggests a need to engage in behavioral-health treatment concurrently with/or prior to implantation); the patients filled out questionnaires that assessed past psychiatric diagnoses, pain disability, and pain numerical rating scale (NRS) at 3- (N= 128) and 6-months (N=92); and patients’ self-report of satisfaction with SCSs at 3- and 6-months. The majority of patients were male, active duty, and had noncombat-related injuries. The mean age was 45 years. Linear regressions suggest that patients with MHC have worse pain disability outcomes at 3-months. A linear regression suggests that higher PRs predict higher pain NRS ratings and worse pain disability outcomes at 3-months. Linear regression suggests that lower PRs predict higher patients’ self-reported satisfaction with SCSs at 6-months. This project suggests that it is important for providers working in the MHS to assess patients’ co-morbid MHCs prior to implementation since these factors appear to impact pain disability ratings, NRS, and patients’ self-reported satisfaction with implantation.