More research is showing that high-frequency spinal cord stimulation (SCS) provides “superior clinical outcomes” compared to conventional SCS stimulation for people with chronic back and leg pain, according to a study published in the latest issue of Neurosurgery.
The high-frequency stimulation is called “HF10” and “offers lasting reductions in back and leg pain after other treatments have failed,” said Dr. Leonardo Kapural of the Center for Clinical Research and Carolinas Pain Institute, and co-author of the study.
The study followed 171 people with moderate to severe back and leg pain that had tried a myriad of other treatments without success. The participants had chronic pain for an average of 14 years and were treated at 11 pain clinics in the US. The vast majority – almost 90% – had had previous back surgery, and about the same number were currently taking opioids.
Study participants were randomly assigned to one of two groups. One group was treated with the HF10, where stimulation is delivered to the spinal cord at a rate of 10 kilohertz for short periods of time. The other group was treated with traditional SCS therapy, where stimulation is delivered to the spinal cord at a lower frequency and for longer periods of time.
At three months, scores for back and leg pain decreased by at least half in more than 80 percent of patients receiving HF10. Those who received conventional SCS achieved similar responses in back pain for 44 percent of patients and in leg pain for 55 percent.
At two years’ follow-up, the HF10 group still had higher response rates: 76 versus 49 percent for back pain and 73 versus 49 percent for leg pain.
On a 0-to-10 rating scale, average back pain score decreased by 5 points with HF10 versus about 3 points for traditional SCS.
Extending follow-up to two years “provides physicians, patients, and payers with rigorous evidence demonstrating the durability of SCS in treating chronic pain,” Dr. Kapural and coauthors write. They note that the results are “particularly impressive” given the patients’ long history of pain and lack of response to other treatments, including back surgery.