High Frequency 10 kHz Spinal Cord Stimulation as a First Line Programming Option for Patients With Chronic Pain: A Retrospective Study and Review of the Current Evidence

Mickey E Abraham; Justin Gold; Akhil Dondapati; Kristin Sheaffer; Julian L Gendreau; Antonios Mammis

doi:10.7759/cureus.17220

High Frequency 10 kHz Spinal Cord Stimulation as a First Line Programming Option for Patients With Chronic Pain: A Retrospective Study and Review of the Current Evidence

Cureus. 2021 Aug 16;13(8):e17220. doi: 10.7759/cureus.17220. eCollection 2021 Aug.

Authors

Mickey E Abraham¹, Justin Gold², Akhil Dondapati³, Kristin Sheaffer⁴, Julian L Gendreau⁵, Antonios Mammis²

Affiliations

¹ Neurological Surgery, University of California, La Jolla, USA.
² Department of Neurosurgery, Rutgers New Jersey Medical School, Newark, USA.
³ Department of Neurosurgery, Rutger New Jersey Medical School, Newark, USA.
⁴ Orthopedic Surgery, Mercer University School of Medicine, Savannah, USA.
⁵ Department of Biomedical Engineering, Johns Hopkins Whiting School of Engineering, Baltimore, USA.

Abstract

Introduction Neuromodulation is an evolving and increasingly popular therapy for chronic pain management. Recent data suggest that novel waveforms have demonstrated greater benefit over traditional spinal cord stimulation (SCS). The authors conducted a retrospective review of patients undergoing high-frequency 10 kHz SCS at a single tertiary medical center for the purpose of contributing further evidence to this growing body of data. The literature of high-frequency SCS published to date was also reviewed. Methods A retrospective chart review was performed for patients with chronic pain syndrome, including failed back surgery syndrome and sciatica alone, who underwent high-frequency SCS at 10 kHz. This data was analyzed using R software (R Foundation for Statistical Computing, Vienna, Austria) for statistical analysis. The PubMed database was searched for relevant articles using the search terms "high frequency," "10 kHz," and "spinal cord stimulation." All relevant studies conducted to date were included in this literature review. Results Twenty-one patients had complete follow-up data and were included in this study. Of the 21 patients, 85.7% subjectively reported post-operative pain relief while 71.4% of the total patients reported pain relief by ≥ 50%. There was a statistically significant decrease in mean VAS scores from pre-operative to 12-months post-operative (8.52 vs 4.37, p < 0.001). Additionally, 76.5% of patients subjectively reported improvements in sleep and activities of daily living. Recent studies indicate that high-frequency SCS appears to be a viable option for delivering quality pain relief in patients for chronic regional pain syndrome, failed back surgery syndrome, sciatica, and also pain in the upper cervical region of the spine. Conclusion This article provides evidence both with the authors' own institutional data and from the currently published literature for the efficacy of using high-frequency SCS at 10 kHz as a first-line programming option for patients undergoing SCS.

Keywords: 10 khz; back pain; chronic pain; high frequency; spinal cord; stimulation.