A new study published in Neuromodulation demonstrates that automatic, daily remote monitoring of spinal cord stimulation (SCS) devices enables the first real-time visibility into post-implant therapy use, including the identification of “virtual explants” — patients with prolonged device inactivity who have not undergone surgical removal. In the study, patients using the Prospera® SCS system — the only SCS device with automatic, objective, daily remote monitoring and remote programing — maintained high rates of therapy use and low explant rates. These findings support adoption of real-time remote monitoring as a new standard for long-term SCS device management.

Historically, post-implant SCS management has relied on patients to recognize device issues and seek follow-up care, often leading to suboptimal therapy, delayed interventions, and underreported discontinuation or virtual explants.2 Without access to real-time data, prior studies evaluating SCS explant rates were limited to surgical removals and failed to account for virtual explants, likely underestimating the true rate of therapy discontinuation.

“Until now, clinicians and manufacturers had limited objective visibility into long-term SCS use, true explant rates or the ability to detect virtual explants, and often had to rely on patient self-reporting,” said lead author, Jason Pope, M.D., Evolve Restorative Center, Santa Rosa, CA. “These results show for the first time that remote monitoring provides real-time, comprehensive insights into therapy use and device status, suggesting that proactive care is critical to identify and address device issues and support therapy utilization.”

This retrospective analysis is the first to use automated monitoring data to evaluate explant rates, active utilization, and virtual explants in real-world practice. It included 500 consecutive U.S. patients with chronic low back and/or leg pain implanted with the Prospera® SCS system. The platform’s remote monitoring capabilities allow early detection of device issues, and BIOTRONIK Neuro’s Embrace One™ Care Team intervenes rapidly with remote adjustments and education, reducing the need for in-person visits and potentially improving long-term outcomes for patients.

Key findings include:
95.1% of patients remained implanted (median implant duration 364 days)
4.9% were explanted, with only 2.0% due to diminished pain relief; far lower than historically reported estimates3
96.8% of implanted patients were actively using therapy
Less than 1% were classified as virtual explants (prolonged device inactivity without undergoing explant)

“BIOTRONIK Neuro offers the most comprehensive remote management solution in SCS, which provides an unprecedented level of data and new opportunities to generate real-world evidence that drives ongoing therapy advancements.” said Todd Langevin, President of BIOTRONIK Neuro. “The high rates of therapy adherence seen in this study reinforce the value of shifting post-implant care from reactive to proactive management. Because we don’t rely on patients to detect and report device issues, we reduce the burden on patients and clinicians, and instead offer real-time support to optimize therapy.”