This study aimed to evaluate the efficacy of spinal cord stimulation (SCS) in improving tissue perfusion and functional outcomes in patients with thromboangiitis obliterans (TAO), while assessing its impact on ulcer healing and amputation rates.

This single-center retrospective study analyzed 10 TAO patients undergoing SCS implantation (2015–2024). Perfusion parameters (TcPO ₂ , LDF) were assessed at rest and during orthostatic test, with pain-free walking distance measured pre- and postoperatively. Inclusion required Fontaine stage ≥IIb, failed revascularization/conservative therapy, and efficient trial stimulation (≥50% VAS reduction or ≥20% walking distance improvement).

SCS implantation yielded significant improvements across multiple parameters. Pain-free walking distance increased by 264.5% (p = 0.05), while tissue perfusion showed differential enhancement: resting TcPO ₂ improved by 68.5% (p = 0.5) with stable LDF values (p = 0.39), whereas orthostatic testing demonstrated 39.5% TcPO ₂ (p = 0.46) and 39.5% LDF (p = 0.42) improvements. Fontaine stage improved in 60% of patients, with 80% ulcer healing and 10% amputation rates observed during follow-up.

Spinal cord stimulation shows promise as a safe and effective treatment for thromboangiitis obliterans, improving walking capacity, tissue perfusion, and ulcer healing while reducing amputation rates. These findings support SCS as a viable therapeutic option for TAO patients unresponsive to standard therapies.