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A novel triage tool designed to accelerate the identification and referral of patients with chronic low back and leg pain (CLBLP) for spinal cord stimulation (SCS) has been developed and tested by a multidisciplinary team at Radboudumc and the Sint Maartenskliniek.
Chronic low back and leg pain is a debilitating condition affecting millions worldwide. In recent years, delayed elective care and growing waiting lists increasingly resulted in postponed surgeries for patients with CLBLP. This was particularly detrimental for patients with chronic CLBLP who were candidates for SCS, as delays are associated with an increase in pain, pain medication intake and a decline in mental health. This triage tool shows promises a faster, more effective way to direct patients toward appropriate care, reducing delays and improving clinical results. The study was recently published in the European Journal of Pain .
The study at a glance
The researchers aimed to create a tool that identifies patients eligible for SCS—an intervention known to alleviate chronic pain and improve quality of life. Drawing from Dutch guidelines, literature, and expert consultations, they developed criteria such as pain duration, severity, and neuropathic characteristics. Over 1,000 patients were assessed, and the tool demonstrated excellent usability (System Usability Score: 74.2), reliability (Fleiss’ Kappa: 0.79), and accuracy (sensitivity: 100%, specificity: 98.8%).
The triage process effectively reduced wait times for orthopedic consultations and enabled faster referrals for SCS evaluation. Patients who were flagged as candidates underwent an accelerated care pathway, bypassing months of delays common in traditional systems.
Significance and next steps
This tool is an important step forward in personalizing chronic pain management. By streamlining patient selection for SCS, it can help improve healthcare efficiency and patient outcomes while potentially alleviating the strain on medical systems caused by long waiting lists.
The next phase involves refining the tool to further enhance its predictive capabilities and integrating it into broader clinical workflows, such as digital health platforms and multidisciplinary care models. With additional funding, the researchers aim to incorporate psychosocial factors, expand its application to diverse healthcare settings, and assess its impact on long-term outcomes. They envision a future where this tool not only shortens wait times but also helps healthcare systems manage resources more effectively.
This research is part of Radboudumc Research Program: Quality of life of vulnerable patients
About the publication
Bastiaens, F., van Hooff, M.L., Bruaset, I.J., van den Eede, E., Maandag, N.J.G., Kurt, E., Schel-Huisman, M.C.M., Wegener, J.T. and Vissers, K.C.P. (2025), Development and Feasibility Study of a Triage Tool for Early Referral to Spinal Cord Stimulation for Patients With Chronic Low Back and Leg Pain. Eur J Pain, 29: e4780. https://doi.org/10.1002/ejp.4780
