Tags

Type your tag names separated by a space and hit enter

Burst spinal cord stimulation evaluated in patients with failed back surgery syndrome and painful diabetic neuropathy.
Neuromodulation. 2014 Feb; 17(2):152-9.N

Abstract

OBJECTIVE

Spinal cord stimulation (SCS) is used for treating intractable neuropathic pain. Generally, it induces paresthesia in the area covered by SCS. Burst SCS was introduced as a new stimulation paradigm with good pain relief without causing paresthesia. Good results have been obtained in patients who were naive to SCS. In this study we assess the effectiveness of burst stimulation in three groups of chronic pain patients who are already familiar with SCS and the accompanying paresthesia.

METHODS

Forty-eight patients with at least six months of conventional, tonic stimulation tested burst stimulation for a period of two weeks. They were classified in three different groups: a cross-section of our population with painful diabetic neuropathy (PDN), a cross-section of our population with failed back surgery syndrome (FBSS), and FBSS patients who over time had become poor responders (PR) to SCS. Visual analog scale scores for pain were assessed prior to implantation, with tonic stimulation, and after two weeks of burst stimulation.

RESULTS

Burst stimulation reduced pain significantly for almost all patients. When compared with tonic stimulation, burst stimulation led to a significant additional pain reduction of on average 44% in patients with PDN (p < 0.001) and 28% in patients with FBSS (p < 0.01). Patients from the PR group benefitted less from burst stimulation on average. In addition, burst stimulation caused little or no paresthesia whereas tonic stimulation did induce paresthesia. Most patients preferred burst stimulation, but several preferred tonic stimulation because the paresthesia assured them that the SCS was working.

CONCLUSION

About 60% of the patients with tonic SCS experienced further pain reduction upon application of burst stimulation.

Authors+Show Affiliations

Department of Neurosurgery, Medisch Spectrum Twente, Enschede, The Netherlands; Department of Clinical Neurophysiology, University of Twente, Enschede, The Netherlands; The Neurobionics Foundation, Enschede, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

24655043

Citation

de Vos, Cecile C., et al. "Burst Spinal Cord Stimulation Evaluated in Patients With Failed Back Surgery Syndrome and Painful Diabetic Neuropathy." Neuromodulation : Journal of the International Neuromodulation Society, vol. 17, no. 2, 2014, pp. 152-9.
de Vos CC, Bom MJ, Vanneste S, et al. Burst spinal cord stimulation evaluated in patients with failed back surgery syndrome and painful diabetic neuropathy. Neuromodulation. 2014;17(2):152-9.
de Vos, C. C., Bom, M. J., Vanneste, S., Lenders, M. W., & de Ridder, D. (2014). Burst spinal cord stimulation evaluated in patients with failed back surgery syndrome and painful diabetic neuropathy. Neuromodulation : Journal of the International Neuromodulation Society, 17(2), 152-9. https://doi.org/10.1111/ner.12116
de Vos CC, et al. Burst Spinal Cord Stimulation Evaluated in Patients With Failed Back Surgery Syndrome and Painful Diabetic Neuropathy. Neuromodulation. 2014;17(2):152-9. PubMed PMID: 24655043.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Burst spinal cord stimulation evaluated in patients with failed back surgery syndrome and painful diabetic neuropathy. AU - de Vos,Cecile C, AU - Bom,Marjanne J, AU - Vanneste,Sven, AU - Lenders,Mathieu W P M, AU - de Ridder,Dirk, Y1 - 2013/09/24/ PY - 2013/02/21/received PY - 2013/07/04/revised PY - 2013/08/06/accepted PY - 2014/3/25/entrez PY - 2014/3/25/pubmed PY - 2014/12/15/medline KW - Burst stimulation KW - diabetic neuropathic pain (DNP) KW - failed back surgery syndrome (FBSS) KW - paresthesia KW - spinal cord stimulation (SCS) SP - 152 EP - 9 JF - Neuromodulation : journal of the International Neuromodulation Society JO - Neuromodulation VL - 17 IS - 2 N2 - OBJECTIVE: Spinal cord stimulation (SCS) is used for treating intractable neuropathic pain. Generally, it induces paresthesia in the area covered by SCS. Burst SCS was introduced as a new stimulation paradigm with good pain relief without causing paresthesia. Good results have been obtained in patients who were naive to SCS. In this study we assess the effectiveness of burst stimulation in three groups of chronic pain patients who are already familiar with SCS and the accompanying paresthesia. METHODS: Forty-eight patients with at least six months of conventional, tonic stimulation tested burst stimulation for a period of two weeks. They were classified in three different groups: a cross-section of our population with painful diabetic neuropathy (PDN), a cross-section of our population with failed back surgery syndrome (FBSS), and FBSS patients who over time had become poor responders (PR) to SCS. Visual analog scale scores for pain were assessed prior to implantation, with tonic stimulation, and after two weeks of burst stimulation. RESULTS: Burst stimulation reduced pain significantly for almost all patients. When compared with tonic stimulation, burst stimulation led to a significant additional pain reduction of on average 44% in patients with PDN (p < 0.001) and 28% in patients with FBSS (p < 0.01). Patients from the PR group benefitted less from burst stimulation on average. In addition, burst stimulation caused little or no paresthesia whereas tonic stimulation did induce paresthesia. Most patients preferred burst stimulation, but several preferred tonic stimulation because the paresthesia assured them that the SCS was working. CONCLUSION: About 60% of the patients with tonic SCS experienced further pain reduction upon application of burst stimulation. SN - 1525-1403 UR - https://www.unboundmedicine.com/medline/citation/24655043/Burst_spinal_cord_stimulation_evaluated_in_patients_with_failed_back_surgery_syndrome_and_painful_diabetic_neuropathy_ L2 - https://doi.org/10.1111/ner.12116 DB - PRIME DP - Unbound Medicine ER -