Affiliation:
1. Hunter Pain Clinic, Broadmeadow, NSW, Australia
Abstract
Background: High frequency spinal cord stimulation at 10 kHz (HF10 therapy) represents a
prominent advance in spinal cord stimulation (SCS) therapy, having demonstrated enhanced
efficacy in patients with back and leg pain and pain relief without paresthesia that is sustained at
24 months post implant.
Objective: To report on the effectiveness HF10 SCS therapy for a wide range of intractable pain
conditions in clinical practice.
Study Design: Retrospective investigation of 256 patients who trialed HF10 SCS for chronic
intractable pain of various etiologies.
Setting: Three Australian pain clinics.
Methods: Two hundred fifty-six patients trialed HF10 SCS with view of a permanent implant
if successful. Pain distributions included back + leg, back only, head ± neck, and neck ± arm/
shoulder. About 30% of patients had previously failed traditional low-frequency paresthesiabased stimulation, while the remaining cohort were either highly refractory to treatment or not
recommended by the pain physician for traditional SCS. Pain scores (numerical pain rating scale
– NPRS) and functional outcome measures (Oswestry Disability Index – ODI; and activity tolerance
times) were assessed at baseline, post-trial, and at 3 and 6 months post-implant as available in the
medical records.
Results: Of the 256 patients, 189 (73%) reported a positive trial and were implanted. Patients
with back + leg pain demonstrated the highest trial success rate (81%). A mean reduction in
pain, among those for whom data were available, of 50% was sustained up to 6 months postimplant across the entire patient population. Sixty-eight percent of patients who failed traditional
SCS reported a positive trial and mean pain relief at 6 months was 49% (P < 0.001). An 8.6 point
reduction in ODI (21%) at 6 months and improved sitting, standing, and walking tolerances were
also reported.
Limitations: As data was collected retrospectively, missing data points were unavoidable; this
was primarily due to inconsistent data collection and patients being lost to follow-up. Patient
populations were diverse and a control group was not appropriate in this setting.
Conclusions: These retrospective results demonstrate a significant advancement for patients
suffering with chronic intractable pain and are consistent with recently published clinical results for
HF10 SCS. HF10 SCS appears to be a viable, paresthesia-free alternative to traditional SCS, with
high trial success rates, demonstrated effectiveness in a range of pain distributions including those
typically difficult to treat with traditional SCS, and the possibility to restore pain control in patients
who have previously failed traditional SCS.
Key words: Spinal cord stimulation, high frequency stimulation, HF10, paresthesia-free
stimulation, back pain, leg pain, cervical pain, neuromodulation
Publisher
American Society of Interventional Pain Physicians
Subject
Anesthesiology and Pain Medicine
Cited by
45 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献