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High‐Frequency Spinal Cord Stimulation at 10 kHz for the Treatment of Complex Regional Pain Syndrome: A Case Series of Patients With or Without Previous Spinal Cord Stimulator Implantation
Author(s) -
Gill Jatinder S.,
Asgerally Abbas,
Simopoulos Thomas T.
Publication year - 2019
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12739
Subject(s) - medicine , spinal cord stimulator , chronic pain , complex regional pain syndrome , anesthesia , adverse effect , spinal cord , retrospective cohort study , spinal cord stimulation , confidence interval , cohort , intractable pain , implant , neuropathic pain , cohort study , surgery , physical therapy , psychiatry
Background High‐frequency spinal cord stimulation at 10 kHz ( HF 10‐ SCS ) has been demonstrated to provide enhanced and durable pain relief in patients with chronic back and radiating leg pain. Patients with pain related to complex regional pain syndrome ( CRPS ) in the chronic stages are commonly challenging to treat and often receive traditional spinal cord stimulation (SCS). Very little information is currently available about the therapeutic outcomes following application of high‐frequency stimulation in this cohort of patients. Methods The purpose of the retrospective case series was to report on the initial experience of HF 10‐ SCS in 13 patients with CRPS , some of whom had been exposed to low‐frequency SCS . A temporary trial of HF 10‐ SCS was carried out for 1 week, and those achieving a minimum of 50% pain intensity reduction underwent implantation. Successful responders were those who achieved a 50% decrease in pain intensity on subsequent follow‐up. Results Thirteen patients were trialed, 12 of whom went on to receive a permanent implant. Of the patients receiving permanent implants, the responder rate (50% pain relief) was 67% (95% confidence interval [ CI ] 0.34 to 0.90), with an average follow‐up period of 12.1 ± 4.6 months. Of the 5 patients who had sympathetically independent pain, 3 were responders, and of the 7 patients who had sympathetically mediated pain, 5 were responders. There were no adverse events. Conclusion This small case series suggests that HF10‐SCS may be a viable option for patients with CRPS who have chronic intractable pain, including those who had suboptimal results from traditional SCS .