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Proposal for Chinese Expert Consensus on Transcutaneous Spinal Cord Stimulation for Painful Diabetic Neuropathy (2024)

Received: 18 September 2025     Accepted: 14 October 2025     Published: 7 November 2025
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Abstract

China has the highest prevalence of diabetes worldwide, leading to substantial healthcare expenditures and a growing burden of diabetes-related complications. Among these, painful diabetic neuropathy (PDN) has become a major public health issue that significantly reduces patients’ quality of life. Conventional treatments, such as blood glucose control and pharmacotherapy, provide limited efficacy and benefit only a subset of patients. In recent years, spinal cord stimulation (SCS) has emerged as an effective therapeutic approach for PDN, particularly with the advancement of high-frequency spinal cord stimulation (HF-SCS) technology, which has demonstrated superior clinical outcomes. To address the increasing clinical need for standardized management, the Neuromodulation Professional Committee of the Chinese Medical Doctor Association has developed the Chinese Expert Consensus on Percutaneous Spinal Cord Stimulation for the Treatment of Painful Diabetic Neuropathy (2024). This consensus aims to offer scientific and practical guidance for the clinical application of SCS in PDN. It follows both international and domestic guideline standards and employs the Delphi method and expert panel discussions to formulate evidence-based recommendations. The consensus seeks to optimize treatment strategies, improve patient outcomes, identify existing research gaps, and guide future studies to strengthen the evidence base for standardized PDN diagnosis and management in China.

Published in International Journal of Pain Research (Volume 1, Issue 4)
DOI 10.11648/j.ijpr.20250104.16
Page(s) 150-156
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Percutaneous Spinal Cord Stimulation, Painful Diabetic Neuropathy, Guideline, Consensus Document

References
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[2] International Diabetes Federation. Facts and figures: diabetes prevalence [Z]. Belgium, 2024.
[3] Wang L, Peng W, Zhao Z, et al. Prevalence and treatment of diabetes in China, 2013-2018 [J]. JAMA, 2021, 326(24): 2498-2506.
[4] Xu L, Sun Z, Casserly E, et al. Advances in interventional therapies for painful diabetic neuropathy: a systematic review [J]. Anesth Analg, 2022, 134(6): 1215-1228.
[5] Geelen CC, Kindermans HP, van den Bergh JP, et al. Perceived physical activity decline as a mediator in the relationship between pain catastrophizing, disability, and quality of life in patients with painful diabetic neuropathy [J]. Pain Prac, 2017, 17(3): 320-328.
[6] Ali R, Schwalb JM. History and future of spinal cord stimulation [J]. Neurosurgery, 2024, 94(1): 20-28.
[7] Petersen EA, Stauss TG, Scowcroft JA, et al. Effect of high-frequency (10-kHz) spinal cord stimulation in patients with painful diabetic neuropathy: a randomized clinical trial [J]. JAMA Neurol, 2021, 78(6): 687-698.
[8] Kilchukov M, Kiselev R, Gorbatykh A, et al. High-frequency versus low-frequency spinal cord stimulation in treatment of chronic limb-threatening ischemia: short-term results of a randomized trial [J]. Stereotact Funct Neurosurg, 2023, 101(1): 1-11.
[9] Tieppo Francio V, Polston KF, Murphy MT, et al. Management of chronic and neuropathic pain with 10 kHz spinal cord stimulation technology: summary of findings from preclinical and clinical studies [J]. Biomedicines, 2021, 9(6): 644.
[10] Brouwers MC, Kerkvliet K, Spithoff K, et al. The AGREE Reporting Checklist: a tool to improve reporting of clinical practice guidelines [J]. BMJ, 2016, 352(1): i1152.
[11] Chen Y, Yang K, Marušic A, et al. A reporting tool for practice guidelines in health care: the RIGHT Statement [J]. Ann Intern Med, 2017, 166(2): 128-132.
[12] World Health Organization. Declaration of interests for WHO experts [Z]. Geneva: World Health Organization Press, 2022.
[13] Morgano GP, Fulceri F, Nardocci F, et al. Introduction and methods of the evidence-based guidelines for the diagnosis and management of autism spectrum disorder by the Italian National Institute of Health [J]. Health Qual Life Outcomes, 2020, 18(1): 81.
[14] Oxford Centre for Evidence-Based Medicine. The 2011 Oxford CEBM levels of evidence: introductory document [Z]. Oxford: University of Oxford, 2023.
[15] Diamond IR, Grant RC, Feldman BM, et al. Defining consensus: a systematic review recommends methodologic criteria for reporting of Delphi studies [J]. J Clin Epidemiol, 2014, 67(4): 401-409.
[16] Petersen EA. Spinal cord stimulation in painful diabetic neuropathy: an overview [J]. Diabetes Res Clin Pract, 2023, Suppl 1(1): 110760.
[17] Deer TR, Russo MA, Grider JS, et al. The neurostimulation appropriateness consensus committee (NACC): recommendations for surgical technique for spinal cord stimulation [J]. Neuromodulation, 2022, 25(1): 1-34.
[18] Narouze S, Benzon HT, Provenzano D, et al. Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications (Second Edition): Guidelines From the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anesthesia and Pain Therapy, the American Academy of Pain Medicine, the International Neuromodulation Society, the North American Neuromodulation Society, and the World Institute of Pain [J]. Reg Anesth Pain Med, 2018, 43(3): 225-262.
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  • APA Style

    Chengjiang, L., Siyao, Z., Yifu, L., Qiaomin, X., Wensheng, Z., et al. (2025). Proposal for Chinese Expert Consensus on Transcutaneous Spinal Cord Stimulation for Painful Diabetic Neuropathy (2024). International Journal of Pain Research, 1(4), 150-156. https://doi.org/10.11648/j.ijpr.20250104.16

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    ACS Style

    Chengjiang, L.; Siyao, Z.; Yifu, L.; Qiaomin, X.; Wensheng, Z., et al. Proposal for Chinese Expert Consensus on Transcutaneous Spinal Cord Stimulation for Painful Diabetic Neuropathy (2024). . 2025, 1(4), 150-156. doi: 10.11648/j.ijpr.20250104.16

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    AMA Style

    Chengjiang L, Siyao Z, Yifu L, Qiaomin X, Wensheng Z, et al. Proposal for Chinese Expert Consensus on Transcutaneous Spinal Cord Stimulation for Painful Diabetic Neuropathy (2024). . 2025;1(4):150-156. doi: 10.11648/j.ijpr.20250104.16

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  • @article{10.11648/j.ijpr.20250104.16,
      author = {Liu Chengjiang and Zheng Siyao and Liang Yifu and Xiang Qiaomin and Zhao Wensheng and Zhang Aichun and Li Yunze and Jin Yi and Feng Zhiying},
      title = {Proposal for Chinese Expert Consensus on Transcutaneous Spinal Cord Stimulation for Painful Diabetic Neuropathy (2024)
    },
      journal = {International Journal of Pain Research},
      volume = {1},
      number = {4},
      pages = {150-156},
      doi = {10.11648/j.ijpr.20250104.16},
      url = {https://doi.org/10.11648/j.ijpr.20250104.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijpr.20250104.16},
      abstract = {China has the highest prevalence of diabetes worldwide, leading to substantial healthcare expenditures and a growing burden of diabetes-related complications. Among these, painful diabetic neuropathy (PDN) has become a major public health issue that significantly reduces patients’ quality of life. Conventional treatments, such as blood glucose control and pharmacotherapy, provide limited efficacy and benefit only a subset of patients. In recent years, spinal cord stimulation (SCS) has emerged as an effective therapeutic approach for PDN, particularly with the advancement of high-frequency spinal cord stimulation (HF-SCS) technology, which has demonstrated superior clinical outcomes. To address the increasing clinical need for standardized management, the Neuromodulation Professional Committee of the Chinese Medical Doctor Association has developed the Chinese Expert Consensus on Percutaneous Spinal Cord Stimulation for the Treatment of Painful Diabetic Neuropathy (2024). This consensus aims to offer scientific and practical guidance for the clinical application of SCS in PDN. It follows both international and domestic guideline standards and employs the Delphi method and expert panel discussions to formulate evidence-based recommendations. The consensus seeks to optimize treatment strategies, improve patient outcomes, identify existing research gaps, and guide future studies to strengthen the evidence base for standardized PDN diagnosis and management in China.
    },
     year = {2025}
    }
    

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    T1  - Proposal for Chinese Expert Consensus on Transcutaneous Spinal Cord Stimulation for Painful Diabetic Neuropathy (2024)
    
    AU  - Liu Chengjiang
    AU  - Zheng Siyao
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    AU  - Li Yunze
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    AU  - Feng Zhiying
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    AB  - China has the highest prevalence of diabetes worldwide, leading to substantial healthcare expenditures and a growing burden of diabetes-related complications. Among these, painful diabetic neuropathy (PDN) has become a major public health issue that significantly reduces patients’ quality of life. Conventional treatments, such as blood glucose control and pharmacotherapy, provide limited efficacy and benefit only a subset of patients. In recent years, spinal cord stimulation (SCS) has emerged as an effective therapeutic approach for PDN, particularly with the advancement of high-frequency spinal cord stimulation (HF-SCS) technology, which has demonstrated superior clinical outcomes. To address the increasing clinical need for standardized management, the Neuromodulation Professional Committee of the Chinese Medical Doctor Association has developed the Chinese Expert Consensus on Percutaneous Spinal Cord Stimulation for the Treatment of Painful Diabetic Neuropathy (2024). This consensus aims to offer scientific and practical guidance for the clinical application of SCS in PDN. It follows both international and domestic guideline standards and employs the Delphi method and expert panel discussions to formulate evidence-based recommendations. The consensus seeks to optimize treatment strategies, improve patient outcomes, identify existing research gaps, and guide future studies to strengthen the evidence base for standardized PDN diagnosis and management in China.
    
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