Title
Burst spinal cord stimulation evaluated in patients with failed back surgery syndrome and painful diabetic neuropathy Burst spinal cord stimulation evaluated in patients with failed back surgery syndrome and painful diabetic neuropathy
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
Oxford ,
Subject
Human medicine
Source (journal)
Neuromodulation. - Oxford
Volume/pages
17(2014) :2 , p. 152-159
ISSN
1094-7159
ISI
000333163500010
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
ObjectiveSpinal 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. MethodsForty-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. ResultsBurst 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. ConclusionAbout 60% of the patients with tonic SCS experienced further pain reduction upon application of burst stimulation.
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