Short-Term Spinal Cord Stimulation Improves Consciousness Level in Prolonged Disorders of Consciousness

BACKGROUND: Short-term spinal cord stimulation (stSCS) has emerged as a potential therapy for prolonged disorders of consciousness (pDOC), but its efficacy remains debated owing to prior studies lacking controls. We evaluated stSCS effectiveness using propensity score matching (PSM) and inverse probability treatment weighting (IPTW) to adjust for baseline differences between treated and untreated patients with pDOC. METHODS: This retrospective analysis included 186 patients with pDOC (26 stSCS-treated, 160 non-stSCS) treated at our center from 2019 to 2024. PSM (3:1 ratio) and IPTW were employed to compare consciousness improvement rates at 3 and 6 months post-onset. Univariate logistic regression identified stSCS as an independent prognostic factor. RESULTS: stSCS-treated patients demonstrated significantly higher consciousness improvement rates than non-stSCS controls at 3 months (IPTW-adjusted odds ratio [OR] 3.475, 95% confidence interval (CI) 1.482-8.529, p = 0.003; PSM OR 2.524, 95% CI 1.018-6.529, p = 0.04). Benefits persisted at 6 months (IPTW OR 2.666, 95% CI 1.096-7.244, p = 0.029; PSM OR 2.789, 95% CI 1.049-8.458, p = 0.038). Regression confirmed stSCS as an independent predictor of improved outcomes (p < 0.05). CONCLUSIONS: This study provides preliminary evidence that suggests stSCS may be efficacious in pDOC, as indicated by sustained benefits observed at 3 and 6 months. Findings highlight the potential value of early stSCS intervention for consciousness recovery; however, further validation in larger cohorts is needed.