Dr. S. Chris Tian, an expert in interventional pain management at University Orthopedics, recently became the first physician in Rhode Island to successfully implant a Closed-Loop Spinal Cord Stimulator (SCS) — marking a major milestone in the state’s advancement of neuromodulation-based pain care.
The landmark procedure was performed on October 27, 2025, at University Orthopedics’ East Bay Surgery Center in East Providence and is meant to help patients with chronic spinal or neuropathic pain, including low back pain, sciatica, and peripheral neuropathy, who have exhausted conservative treatments.
The Closed-Loop SCS system represents a new generation of spinal neuromodulation technology. Unlike traditional open-loop stimulators that deliver fixed electrical pulses, closed-loop devices continuously monitor evoked compound action potentials (ECAPs) — the spinal cord’s real-time electrical responses to stimulation — and automatically adjust output to maintain consistent neural activation.
This feedback-controlled approach minimizes overstimulation, reduces loss of efficacy during movement or posture changes, and provides more stable, durable pain relief.
“Closed-loop spinal cord stimulation represents the next frontier in neuromodulation,” said Dr. Tian. “By tailoring stimulation dynamically to the patient’s neural feedback, we can provide safer, more consistent, and longer-lasting pain relief. This technology allows patients to regain control over their lives without the unpredictability often associated with chronic pain.”
Clinical Evidence Supporting Closed-Loop SCS
Peer-reviewed studies have demonstrated significant clinical advantages of closed-loop technology over conventional open-loop systems:
- Superior and sustained pain relief: Patients experience greater long-term reductions in pain intensity and functional impairment compared to open-loop stimulation1.
- Stable neural activation: Real-time ECAP feedback maintains consistent spinal cord activation across posture and activity changes2.
- Improved durability and lower reprogramming burden: Patients require fewer reprogramming sessions and show lower explant rates due to therapy stability3.
About the Procedure
The Closed-Loop SCS is a minimally invasive outpatient procedure performed under local anesthesia with sedation. The system delivers targeted electrical pulses to the dorsal columns of the spinal cord to interrupt chronic neuropathic pain signals. It is indicated for patients with chronic intractable pain of the trunk and/or limbs, including failed back surgery syndrome (FBSS), complex regional pain syndrome (CRPS), and post-laminectomy pain.
Regional Significance
With this achievement, University Orthopedics continues to lead Rhode Island and Southeastern Massachusetts in advanced pain management and neuromodulation innovation, offering patients access to cutting-edge therapies previously available only at large tertiary centers.
Learn More: Patients and referring providers interested in learning more about closed-loop spinal cord stimulation can call 401-457-1500 for more information.
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PBN: UOI Doctor Becomes First in RI to Implant New Spinal Pain Management Tech »