Journal
CURRENT OPINION IN ANESTHESIOLOGY
Volume 29, Issue 5, Pages 590-595Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/ACO.0000000000000379
Keywords
dorsal root ganglion stimulation; high-density stimulation; neuromodulation; new modalities of spinal cord stimulation
Categories
Ask authors/readers for more resources
Purpose of reviewNeurostimulation is a well tolerated, cost-efficient, and effective method to treat chronic pain. Although spinal cord stimulation (SCS) has been shown to help patients, newer modalities such as burst, kilohertz-frequency, and dorsal root ganglion stimulation may provide greater pain relief, fewer paresthesias, and better outcomes.Recent findingsBurst stimulation, programed as five-impulse burst at a frequency of 500Hz, delivers more charge per second than conventional stimulation. Trials of burst stimulation have shown superior pain relief, decreased paresthesias, and patient preference compared with conventional SCS. Kilohertz-frequency SCS uses low-amplitude, high-frequency (10kHz), and short-duration pulses. The SENZA trial showed superiority in both back and leg pain with greater pain relief as well as decreased opioid use. Dorsal root ganglion stimulation stimulates the ganglion cells allowing for precise targeting of pain regions. Multiple studies, including the ACCURATE trial, have shown superior pain relief in multiple conditions.SummaryImprovements in pain control and patient satisfaction suggest that these new stimulation patterns will greatly increase the utility of neurostimulation; however, clinical trials with broader patient populations have to be done to support more extensive use of these therapies.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available