Artikel
High frequency spinal cord stimulation: a new standardized solution for the treatment of chronic low back pain?
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Autoren
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Ronald Richter
- Klinik für Stereotaxie und funktionelle Neurochirurgie, Universitätskliniken zu Köln
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Georgios Matis
- Klinik für Stereotaxie und funktionelle Neurochirurgie, Universitätskliniken zu Köln
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Athanasios Koulousakis
- Klinik für Stereotaxie und funktionelle Neurochirurgie, Universitätskliniken zu Köln
| Veröffentlicht: | 2. Juni 2015 |
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Gliederung
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Objective: Although Spinal Cord Stimulation (SCS) has led to a successful treatment of chronic pain of different origins for the last 40 years, the effect on low back pain is often unsatisfactory. A lot of different options (e.g. Peripheral Nerve Field Stimulation, Burst-stimulation, paddle leads) have been developed during the last years in order to obtain a better effect on low back pain in a higher number of patients. Among these, the paresthesia-free high frequency (HF) SCS (10 kHz) seems to be the most promising one. The goal of this study is to evaluate the effect of HF-SCS in patients with predominant low back pain.
Method: Since April 2014, patients with predominant back pain of different origins were included in this study. Inclusion criteria were FBSS as well as so called "virgin backs". In all patients, two linear leads (8-contacts) were implanted percutaneously in a standard midline position with placing the top of the leads at TH8 and the second one in the middle of TH9 level. The pulse generator (IPG, SENZA™ Spinal Cord Stimulation System, Nevro Corporation, Menlo Park, CA) was implanted after a successful trial phase of max. 14 days. The data were collected prospectively. The outcome was measured with the VAS-scale, as well as with the CSS (Cologne Score Scale: VAS 0-10, QoL 0-10 and Drug Reduction 0-10).
Results: Thirteen patients were included in this study. All patients succeeded the trial phase and the IPG was implanted after a median time of 7 days. A median VAS decrease from 9 to 3,5 was measured. All patients reported a reduction of sleep disturbances (to total pain-free nights) and longer walking distances (>50% increase). The 3 and 6 month follow-up visits presented a median VAS 3,8 and improvement in CSS from 27 points to 11. The satisfaction rate was 92% (pain relief and paresthesia-free stimulation).
Conclusions: The current data show that high frequency SCS decreases low back pain sufficiently and proves to be a reliable treatment option. Due to the standardized lead implantation without any need for intraoperative testing, this method is both simple and comfortable for patients and surgeons.
