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The Evolving Role of High-Frequency Spinal Cord Stimulation as Salvage Therapy in Neurostimulation.
Ghosh, Priyanka E; Gill, Jatinder S; Simopoulos, Thomas.
Afiliación
  • Ghosh PE; Department of Anesthesiology, Weill Cornell Pain Medicine, Weill Cornell Medical College, New York, New York, U.S.A.
  • Gill JS; Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.
  • Simopoulos T; Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.
Pain Pract ; 20(7): 706-713, 2020 09.
Article en En | MEDLINE | ID: mdl-32277865
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Terapia Recuperativa / Dolor Crónico / Manejo del Dolor / Estimulación de la Médula Espinal Tipo de estudio: Observational_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Pain Pract Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Terapia Recuperativa / Dolor Crónico / Manejo del Dolor / Estimulación de la Médula Espinal Tipo de estudio: Observational_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Pain Pract Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos