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Multicenter Study
. 2015 Jul;18(5):361-6.
doi: 10.1111/ner.12294. Epub 2015 Apr 16.

Improved Pain Relief With Burst Spinal Cord Stimulation for Two Weeks in Patients Using Tonic Stimulation: Results From a Small Clinical Study

Peter Courtney  1 , Anthony Espinet  2 , Bruce Mitchell  3 , Marc Russo  4 , Andrew Muir  1 , Paul Verrills  3 , Kristina Davis  5
Affiliations
Multicenter Study

Improved Pain Relief With Burst Spinal Cord Stimulation for Two Weeks in Patients Using Tonic Stimulation: Results From a Small Clinical Study

Peter Courtney et al. Neuromodulation. 2015 Jul.

Abstract

Objectives: Conventional spinal cord stimulation (SCS) delivers a tonic waveform with consistent stream of pulses; burst delivers groups of pulses separated by short pulse-free periods. The current study compared the short-term safety and efficacy of burst with tonic stimulation in subjects already receiving SCS.

Materials and methods: At 4 IRB-approved sites, 22 subjects previously implanted with an SCS device for intractable, chronic pain gave informed consent and received burst stimulation for 14 days. Subjects reported average daily Visual Analog Scale (VAS) for overall, trunk, and limb pain using tonic stimulation and after 7 and 14 days of burst stimulation. Thoughts about pain were assessed using the Pain Catastrophizing Scale. Areas of paresthesia were assessed during tonic and burst stimulation using body maps. Assessment of patient satisfaction and preferred stimulation occurred after 14 days of burst.

Results: Average daily overall VAS reduced 46% from a mean of 53.5 (±20.2) mm during tonic SCS to 28.5 (±18.1) mm during burst (p < 0.001); trunk and limb VAS scores were also reduced by 33% and 51%, respectively. During burst, 16 subjects (73%) reported no paresthesia, 5 (23%) reported a reduction, and 1 (4%) reported increased paresthesia. After 14 days, 21 subjects (95%) reported being very satisfied or satisfied with burst. Burst was preferred by 20 subjects (91%), tonic by 1 (5%), and 1 (5%) reported no preference. Better pain relief was the most common reason cited for preference.

Conclusions: A majority of subjects reported improved pain relief using burst compared with tonic stimulation. Most subjects experienced less paresthesia during burst and preferred burst citing better pain relief.

Keywords: Burst stimulation; chronic pain; spinal cord stimulation; tonic stimulation.

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Figures

Figure 1
Figure 1
VAS Scores at Baseline, 7 days, and 14 days. Mean VAS scores (±SD) during baseline tonic stimulation, after 7 days of burst stimulation, and after 14 days of burst stimulation. * indicates statistically significant difference compared with baseline tonic stimulation (p < 0.05).
See this image and copyright information in PMC

References

    1. Taylor RS. Spinal cord stimulation in complex regional pain syndrome and refractory neuropathic back and leg pain/failed back surgery syndrome: Results of a systematic review and meta‐analysis. J Pain Symptom Manage 2006;31 (4 Suppl.):S13–S19. - PubMed
    1. Kumar K, Taylor RS, Jacques L et al. Spinal cord stimulation versus conventional medical management for neuropathic pain: A multicentre randomised controlled trial in patients with failed back surgery syndrome. Pain 2007;132:179–188. - PubMed
    1. Kumar K, Taylor RS, Jacques L et al. The effects of spinal cord stimulation in neuropathic pain are sustained: a 24‐month follow‐up of the prospective randomized controlled multicenter trial of the effectiveness of spinal cord stimulation. Neurosurgery 2008;63:762–770. - PubMed
    1. Oakley JC, Weiner RL. Spinal cord stimulation for complex regional pain syndrome: a prospective study of 19 patients at two centers. Neuromodulation 1999;2:47–50. - PubMed
    1. DeRidder D, Vanneste S, Plazier M, van der Loo E, Menovsky T. Burst spinal cord stimulation: toward paresthesia‐free pain suppression. Neurosurgery 2010;66:986–990. - PubMed

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