Artikel
10 kHz High-frequency cervical spinal cord stimulation for the treatment of chronic neck and/or upper limb pain
10 kHz Hochfrequenz-Stimulation des zervikalen Rückenmarks zur Behandlung chronischer Nackenschmerzen und/oder Scherzen der oberen Extremitäten
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Autoren
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Faycal El Majdoub
- Klinikum Köln Merheim, Universität Witten/Herdecke, Stereotaxie und Funktionelle Neurochirurgie, Köln, Deutschland
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Ronald Richter
- Klinikum Köln Merheim, Universität Witten/Herdecke, Stereotaxie und Funktionelle Neurochirurgie, Köln, Deutschland
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Simon Schieferdecker
- Klinikum Köln Merheim, Universität Witten/Herdecke, Stereotaxie und Funktionelle Neurochirurgie, Köln, Deutschland
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Mohammad Maarouf
- Klinikum Köln Merheim, Universität Witten/Herdecke, Stereotaxie und Funktionelle Neurochirurgie, Köln, Deutschland
| Veröffentlicht: | 8. Mai 2019 |
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Gliederung
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Objective: Spinal cord stimulation (SCS) delivered at 10 kHz (HF10) substantially impacts the management of chronic back and leg pain. To date HF10 cervical SCS was successfully performed in patients with migraine. The objective of this study was to demonstrate the safety and efficacy of HF10 cervical SCS therapy in patients with chronic neck and upper limb pain.
Methods: Between May 2014 and October 2018, 47 consecutive patients were treated with HF10 cervical SCS therapy in our department. All patients had classic neck and/or upper limb pain (with or without previous surgical treatments) and passed a temporary trial of 2–3 weeks. Responders were defined as having 50% or greater pain reduction with no stimulation-related neurological deficit. To measure the patients’ functionality and health-related psychological impairment, we used the ODI.
Results: Following HF10 cervical SCS therapy, 35 patients with a follow-up >6 months underwent retrospective evaluation. At 6 months, 97.1% of the patients (34/35) were responders to neck and/or upper limb pain. They experienced a median neck pain reduction from VAS 9 to 3 and upper limb pain reduction from VAS 8 to 2. The median reduction of pain medication was 51.6%. The response to HF10 cervical SCS therapy sustained through 12 months (n=21). Regarding the ODI the mean baseline score was 31.7 (range: 21–42). After 3 months the score decreased to 20.5 (range: 6–28) reflecting an improvement of 35.3%. At 6 and 12 months the score remained stable showing values of 20.1 (range: 8–25) and 21.2 (8–26), respectively. In three patients, an infection over the IPG pocket occurred 2.3, 3.3 and 8.7 months after surgery, one patient had a significant lead migration leading to surgical revision. No patient experienced stimulation-related adverse effects.
Conclusion: HF10 cSCS therapy is safe, reduces neck and/or upper limb pain significantly, and increases functional capacity. These results warrant further studies with larger patient series and longer follow-ups.
