Background and aims 
Developing “all-in-one” spinal cord stimulation (SCS) systems with capability for multiple types of neurostimulation paradigms will likely empower patients to identify the best treatment approaches suitable for their needs. Here, we provide observed real-world outcomes in patients who used a new SCS system designed to combine multiple waveform availability, capable of sequential or simultaneous delivery of therapeutic neurostimulation, with an algorithm that enables highly manipulatable control of stimulation field shape.

Methods
This is a consecutive, multi-center case-series based on retrospective chart review as part of an ongoing real-world evaluation of SCS outcomes for chronic pain (Clinicaltrials.gov identifier: NCT01550575). Patients were treated with a newly designed SCS system (Precision Spectra WaveWriter, Boston Scientific) capable of combination therapy (sequential or simultaneous), multiple waveforms and advanced field shapes, and waveform automation for treatment of low back and/or leg pain. 

Results 
To date, 217 patients have been analyzed. A statistically significant improvement in overall targeted pain scores (NRS) at last follow-up was reported (Baseline NRS: 7.5; at last follow-up [96.6 ± 80.9 days] NRS: 2.4; p < 0.0001). Thirty-nine percent of all patients indicated >80% pain relief at their last follow-up. Twenty-two percent (48 of 217) of all patients reported being pain free (NRS = 0) at last follow-up. Updated data will be presented. 

Conclusions 
These results suggest that an SCS system designed to provide combination therapy, multiple waveform options, and enhanced anatomical targeting capabilities, allows for highly effective pain relief outcomes in a patient-specific manner within the real world clinical setting.

OUTCOMES USING AN SCS DEVICE CAPABLE OF DELIVERING COMBINATION THERAPY (SIMULTANEOUS OR SEQUENTIAL) AND ADVANCED WAVEFORMS/FIELD SHAPES