Background and Aims Chronic pain continues to be a leading cause of disability and disease burden globally. Currently, the FDA has approved spinal cord stimulation (SCS) for a variety of chronic pain syndromes, but there is insufficient long-term data regarding the effectiveness of SCS. Knowing that explantations of SCS threaten the cost-effectiveness and overall efficacy of SCS therapy, our goals were to explore the variables involved in device removal and evaluate the long-term outcome of SCS by measuring the explantation rate.

Methods We retrospectively evaluated a cohort of patients who underwent an SCS system implantation at our hospital between January 2011 and December 2020. The Kaplan-Meier product-limit method was used to generate a Kaplan-Meier curve for the time to device explantation. The Log-rank and Tarone-Ware tests were used to compare time do device explantation between groups.

Results Forty-eight patients underwent SCS implantation.

The mean (±SD) follow-up time was 5.5 years (±2.6 years). The estimated mean time to device explantation was 8.4 years (95% confidence interval [CI] = 7.6–9.3). The principal cause for explant was lack/loss of efficacy (44%).

Conclusions Understanding the most common reasons for explantation could improve patient and device selection, which enhances the long-term therapeutic benefit. Nevertheless, further research is needed in order to found predictors of treatment success.

*Local Ethical committee approval has been granted. It was stated that «no ethical approval of the study was necessary since data were properly anonymized and informed consents were obtained at the time of original data collection.»