The Evolving Role of High‐Frequency Spinal Cord Stimulation as Salvage Therapy in Neurostimulation. Issue 7 (15th May 2020)

• Record Type: Journal Article
• Authors: Ghosh, Priyanka E.; Gill, Jatinder S.; Simopoulos, Thomas
• Is Part Of: Pain practice. Volume 20:Issue 7(2020)
• Page Start: 706
• Page End: 713
• Publication Date: 2020-05-15
• Subjects: traditional spinal cord stimulation -- high‐frequency 10‐kHz spinal cord stimulation -- salvage therapy -- neurostimulation; Pain -- Treatment -- Periodicals; 616.0472
• DOI: 10.1111/papr.12898
• Languages: English
• ISSNs: 1530-7085

Abstract

Abstract: Background: High‐frequency 10‐kHz spinal cord stimulation (10‐kHz SCS) has shown promise in multicenter prospective trials for the management of chronic back and leg pain. Traditional spinal cord stimulation (t‐SCS) has a long history of effectiveness in chronic neuropathic syndromes but not uncommonly can fail to provide long‐term relief, leaving a significant group of patients with unsatisfactory outcomes. There is mounting evidence that 10‐kHz SCS may offer relief in this subset of patients. Methods: The purpose of this retrospective analysis was to report a single‐institution long‐term experience of 10‐kHz SCS in patients who did not get adequate pain relief with prior t‐SCS devices. A temporary trial of 10‐kHz SCS was carried out for 7 days, and those experiencing an average of 50% reduction in pain intensity underwent implantation. Patients were classified as moderate responders if relief was 31% to 50% and excellent responders if pain relief exceeded 50%. Results: Thirty‐one patients who had experienced failed t‐SCS primarily from poor paresthesia coverage underwent a trial of 10‐kHz SCS and 29 underwent implantation. Twenty‐eight patients were available for analysis, with 57.1% experiencing 30% response and 46.4% experiencing excellent response at a median follow‐up of 21.2 (±8.4) months. Conclusions: This small single‐institution study suggests that a significant proportion of patients with previously failed t‐SCS may achieve clinically meaningful and durable pain relief with 10‐kHz SCS.