Ganesan Baranidharan1,2, Beatrice Bretherton3,4, Craig Montgomery3, John Titterington3, Tracey Crowther3, Christopher Vannabouathong5, Jason A Inzana5, Anand Rotte6. 1. Leeds Teaching Hospitals NHS Trust Leeds, Leeds, UK. g.baranidharan@nhs.net. 2. Faculty of Medicine and Health, School of Medicine, Leeds, UK. g.baranidharan@nhs.net. 3. Leeds Teaching Hospitals NHS Trust Leeds, Leeds, UK. 4. Faculty of Biomedical Sciences, School of Biological Sciences, Leeds, UK. 5. Telos Partners LLC, San Diego, CA, USA. 6. Nevro Corp, Redwood City, CA, USA. anand.rotte@nevro.com.
Abstract
BACKGROUND: Chronic pain in head, neck, shoulders and upper limbs is debilitating, and patients usually rely on pain medications or surgery to manage their symptoms. However, given the current opioid epidemic, non-pharmacological interventions that reduce pain, such as spinal cord stimulation (SCS), are needed. The purpose of this study was to review the evidence on paresthesia-free 10 kHz SCS therapy for neck and upper extremity pain. METHODS: Systematic literature search was performed for studies reporting outcomes for cervical 10 kHz SCS using date limits from May 2008 to November 2020. The study results were analyzed and described qualitatively. Additionally, when feasible, meta-analyses of the outcome data, with 95% confidence intervals (CIs), were conducted using both the fixed-effects (FE) and random-effects (RE) models. RESULTS: A total of 15 studies were eligible for inclusion. The proportion of patients who achieved ≥ 50% pain reduction was 83% (95% CI 77-89%) in both the FE and RE models. The proportion of patients who reduced/eliminated their opioid consumption was 39% (95% CI 31-46%) in the FE model and 39% (95% CI 31-48%) in the RE model. Pain or discomfort with the implant, lead migration, and infections were potential risks following cervical SCS. Explant rate was 0.1 (95% CI 0.0-0.2) events per 100 person-months, and no patients in the included studies experienced a neurological complication or paresthesia. CONCLUSION: Findings suggest 10 kHz SCS is a promising, safe, minimally invasive alternative for managing chronic upper limb and neck pain.
BACKGROUND:Chronic pain in head, neck, shoulders and upper limbs is debilitating, and patients usually rely on pain medications or surgery to manage their symptoms. However, given the current opioid epidemic, non-pharmacological interventions that reduce pain, such as spinal cord stimulation (SCS), are needed. The purpose of this study was to review the evidence on paresthesia-free 10 kHz SCS therapy for neck and upper extremity pain. METHODS: Systematic literature search was performed for studies reporting outcomes for cervical 10 kHz SCS using date limits from May 2008 to November 2020. The study results were analyzed and described qualitatively. Additionally, when feasible, meta-analyses of the outcome data, with 95% confidence intervals (CIs), were conducted using both the fixed-effects (FE) and random-effects (RE) models. RESULTS: A total of 15 studies were eligible for inclusion. The proportion of patients who achieved ≥ 50% pain reduction was 83% (95% CI 77-89%) in both the FE and RE models. The proportion of patients who reduced/eliminated their opioid consumption was 39% (95% CI 31-46%) in the FE model and 39% (95% CI 31-48%) in the RE model. Pain or discomfort with the implant, lead migration, and infections were potential risks following cervical SCS. Explant rate was 0.1 (95% CI 0.0-0.2) events per 100 person-months, and no patients in the included studies experienced a neurological complication or paresthesia. CONCLUSION: Findings suggest 10 kHz SCS is a promising, safe, minimally invasive alternative for managing chronic upper limb and neck pain.
Authors: Michael C Rowbotham; Lisa Twilling; Pamela S Davies; Lori Reisner; Kirk Taylor; David Mohr Journal: N Engl J Med Date: 2003-03-27 Impact factor: 91.245
Authors: Timothy R Deer; Nagy Mekhail; David Provenzano; Jason Pope; Elliot Krames; Michael Leong; Robert M Levy; David Abejon; Eric Buchser; Allen Burton; Asokumar Buvanendran; Kenneth Candido; David Caraway; Michael Cousins; Michael DeJongste; Sudhir Diwan; Sam Eldabe; Kliment Gatzinsky; Robert D Foreman; Salim Hayek; Philip Kim; Thomas Kinfe; David Kloth; Krishna Kumar; Syed Rizvi; Shivanand P Lad; Liong Liem; Bengt Linderoth; Sean Mackey; Gladstone McDowell; Porter McRoberts; Lawrence Poree; Joshua Prager; Lou Raso; Richard Rauck; Marc Russo; Brian Simpson; Konstantin Slavin; Peter Staats; Michael Stanton-Hicks; Paul Verrills; Joshua Wellington; Kayode Williams; Richard North Journal: Neuromodulation Date: 2014-08
Authors: Timothy R Deer; Ioannis M Skaribas; Nameer Haider; John Salmon; Chong Kim; Christopher Nelson; Jerry Tracy; Anthony Espinet; Todd E Lininger; Robert Tiso; Melinda A Archacki; Stephanie N Washburn Journal: Neuromodulation Date: 2013-09-24
Authors: Jeffrey L Chen; Andrew W Hesseltine; Sara E Nashi; Shawn M Sills; Tory L McJunkin; Sandeep Patil; Manish Bharara; David L Caraway; Elizabeth S Brooks Journal: J Diabetes Sci Technol Date: 2021-11-29