Efficacy of Alternating Conventional Stimulation and High Frequency Stimulation in Improving Spinal Cord Stimulation Outcomes: A Pilot Study
| Autor: | Roy Hwang, Julia Prusik, Julie G. Pilitsis, Yufan Lin, Paul J. Feustel, Vignessh Kumar |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Pain Threshold Time Factors Visual analogue scale Pilot Projects Stimulation Statistics Nonparametric Disability Evaluation 03 medical and health sciences 0302 clinical medicine Patient satisfaction 030202 anesthesiology Rating scale Humans Medicine Aged Pain Measurement Spinal Cord Stimulation Cross-Over Studies High frequency stimulation business.industry In shuffle Chronic pain General Medicine Middle Aged medicine.disease Crossover study Treatment Outcome Anesthesiology and Pain Medicine Neurology Anesthesia Female Neurology (clinical) Chronic Pain business 030217 neurology & neurosurgery |
| Zdroj: | Neuromodulation: Technology at the Neural Interface. 21:466-471 |
| ISSN: | 1094-7159 |
| Popis: | INTRODUCTION Spinal cord stimulation (SCS) is an established, effective method of treating chronic pain. High frequency stimulation (HFS) is an alternative SCS waveform that has been shown to alleviate pain but also necessitates more frequent recharging. The purpose of this pilot study is to evaluate efficacy of alternating conventional stimulation and HFS (termed "shuffle" stimulation) in improving SCS outcomes. METHODS Shuffle stimulation was designed to deliver conventional stimulation in upright positions with relative HFS in lying positions, automated through accelerometer technology. In this 13-week cross-over study, patients were randomized to receiving conventional and shuffle stimulation in four-week blocks. Pain outcomes and sensory testing were compared from preoperative baseline and at the conclusion of each study period. RESULTS Twelve patients completed this study. Two patients showed no change from baseline visual analogue scale (VAS) with either type of stimulation and were excluded from statistical analysis of pain outcomes. Mean numerical rating scale (NRS) scores assessing current pain were significantly lower in shuffle stimulation (4.0 ± 1.6) compared to conventional stimulation (5.8 ± 2.3) (p = 0.024). In the total cohort, 7 of 11 patients preferred shuffle over conventional stimulation. CONCLUSIONS This study generated preliminary evidence showing improved NRS current pain scores in shuffle stimulation compared to conventional stimulation. More patients preferred shuffle stimulation compared to conventional stimulation. Optimizing stimulation when patients are recumbent may increase patient satisfaction and pain control. The potential advantages of shuffle stimulation may warrant further investigation. |
| Databáze: | OpenAIRE |
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