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High‐frequency (10 kHz) spinal cord stimulation (SCS) as a salvage therapy for failed traditional SCS: A narrative review of the available evidence.

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Title: High‐frequency (10 kHz) spinal cord stimulation (SCS) as a salvage therapy for failed traditional SCS: A narrative review of the available evidence.
Authors: Provenzano, David Anthony, Park, Nicholas, Edgar, Deborah, Bovinet, Chris, Tate, Jordan
Source: Pain Practice. Mar2023, Vol. 23 Issue 3, p301-312. 12p. 1 Diagram, 4 Charts.
Subjects: Postoperative pain treatment, Chronic pain treatment, Treatment of backaches, Spinal cord, Lumbar pain, Treatment effectiveness, Radiculopathy, Salvage therapy, Complex regional pain syndromes, Neural stimulation, Pain management, Failed back surgery syndrome
Abstract: Introduction: Traditional spinal cord stimulation (t‐SCS) has been used to treat chronic pain for over 50 years. However, up to 30% of patients undergo explant, with the main indication being loss of efficacy (LoE), and few alternative treatment options exist for these patients. Strategies to mitigate LoE commonly include conversion to another type of SCS (termed 'salvage' or 'rescue'). This review summarizes the existing literature concerning the efficacy and safety of 10 kHz SCS as a salvage therapy. Methods: We searched PubMed, the Cochrane Library, ClinicalTrials.gov, and other sources between January 2009 and April 2021. Records were retained if the authors reported clinical outcomes with a minimum of ≥ 3 months of follow‐up in patients implanted with a Senza® 10 kHz SCS system in an effort to treat t‐SCS LoE. Results: Ten articles were eligible for inclusion, reporting 3 prospective studies and 7 retrospective reviews. In the single study that salvaged patients without a repeat trial prior to surgery, 81% of patients were responders (≥ 50% pain relief from baseline), with mean pain relief of 60%. Among repeat‐trial studies, the responder rate ranged from 46% to 80%, and mean pain relief from 47% to 68%. No unanticipated therapy‐related safety issues were reported among the included articles. Conclusion: Preliminary data suggest that chronic back and/or leg pain patients with t‐SCS LoE can experience improved and durable pain relief after conversion to 10 kHz SCS. However, additional research is needed to define predictors of success and establish whether salvage without a repeat trial is a viable conversion method. [ABSTRACT FROM AUTHOR]
Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: High‐frequency (10 kHz) spinal cord stimulation (SCS) as a salvage therapy for failed traditional SCS: A narrative review of the available evidence.
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  Data: Introduction: Traditional spinal cord stimulation (t‐SCS) has been used to treat chronic pain for over 50 years. However, up to 30% of patients undergo explant, with the main indication being loss of efficacy (LoE), and few alternative treatment options exist for these patients. Strategies to mitigate LoE commonly include conversion to another type of SCS (termed 'salvage' or 'rescue'). This review summarizes the existing literature concerning the efficacy and safety of 10 kHz SCS as a salvage therapy. Methods: We searched PubMed, the Cochrane Library, ClinicalTrials.gov, and other sources between January 2009 and April 2021. Records were retained if the authors reported clinical outcomes with a minimum of ≥ 3 months of follow‐up in patients implanted with a Senza® 10 kHz SCS system in an effort to treat t‐SCS LoE. Results: Ten articles were eligible for inclusion, reporting 3 prospective studies and 7 retrospective reviews. In the single study that salvaged patients without a repeat trial prior to surgery, 81% of patients were responders (≥ 50% pain relief from baseline), with mean pain relief of 60%. Among repeat‐trial studies, the responder rate ranged from 46% to 80%, and mean pain relief from 47% to 68%. No unanticipated therapy‐related safety issues were reported among the included articles. Conclusion: Preliminary data suggest that chronic back and/or leg pain patients with t‐SCS LoE can experience improved and durable pain relief after conversion to 10 kHz SCS. However, additional research is needed to define predictors of success and establish whether salvage without a repeat trial is a viable conversion method. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/papr.13184
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      – Code: eng
        Text: English
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        PageCount: 12
        StartPage: 301
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      – SubjectFull: Postoperative pain treatment
        Type: general
      – SubjectFull: Chronic pain treatment
        Type: general
      – SubjectFull: Treatment of backaches
        Type: general
      – SubjectFull: Spinal cord
        Type: general
      – SubjectFull: Lumbar pain
        Type: general
      – SubjectFull: Treatment effectiveness
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      – SubjectFull: Radiculopathy
        Type: general
      – SubjectFull: Salvage therapy
        Type: general
      – SubjectFull: Complex regional pain syndromes
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      – SubjectFull: Neural stimulation
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      – SubjectFull: Pain management
        Type: general
      – SubjectFull: Failed back surgery syndrome
        Type: general
    Titles:
      – TitleFull: High‐frequency (10 kHz) spinal cord stimulation (SCS) as a salvage therapy for failed traditional SCS: A narrative review of the available evidence.
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              M: 03
              Text: Mar2023
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              Y: 2023
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