Cleveland Clinic, Cleveland, Ohio.
Central Florida Pain Centers, Orlando, Florida.
Pain Med. 2019 Oct 1;20(10):1971-1979. doi: 10.1093/pm/pnz019.
This study aimed to evaluate the wireless Freedom Spinal Cord Stimulator (WSCS) System for the treatment of chronic back and/or leg pain associated with failed back surgery syndrome (FBSS) refractory to standard medical treatment utilizing 10-kHz stimulation (high-frequency [HF]) in comparison with 10-1,500-Hz stimulation (low-frequency [LF]) waveforms.
Ninety-nine subjects were randomized in a 1:1 ratio to receive either HF or LF stimulation waveforms utilizing the same Freedom WSCS System. All subjects were implanted with two 8-electrode arrays in the exact same anatomical positions within the dorsal epidural spinal column, with the top electrode positioned at the T8 and T9 vertebrae levels, respectively, and the wireless receiver placed under the skin in a subcutaneous pocket.
Seventy-two (HF: N = 38; LF: N = 34) subjects had completed the six-month follow-up after an initial 30-day trial period at the time of this report. For both the HF and LF arms, mean visual analog scale (VAS) scores for back and leg pain decreased significantly: 77% and 76%, respectively, for the HF arm and 64% and 64%, respectively, for the LF arm. In addition, most subjects experienced significant improvements in VAS, Oswestry Disability Index, European Quality of Life 5 Dimension questionnaire, Patient Global Impression of Change, and sleep duration.
These preliminary results demonstrate that WSCS devices can reduce FBSS chronic pain substantially with both LF and HF stimulation waveforms over a seven-month period (30-day trial period and six-month post-trial evaluation).
本研究旨在评估无线 Freedom 脊髓刺激器(WSCS)系统治疗慢性腰背和/或下肢疼痛的效果,这些疼痛与失败的腰椎手术综合征(FBSS)相关,且对标准药物治疗无效,采用 10 kHz 刺激(高频 [HF])与 10-1500 Hz 刺激(低频 [LF])进行比较。
99 名受试者以 1:1 的比例随机接受 HF 或 LF 刺激波形,使用相同的 Freedom WSCS 系统。所有受试者均在相同的解剖位置将两个 8 电极阵列植入硬膜外脊柱背部,顶部电极分别位于 T8 和 T9 椎骨水平,无线接收器置于皮下的皮下袋中。
在初始 30 天试验期后进行了 6 个月的随访,此时报告了 72 名(HF:N=38;LF:N=34)受试者完成了随访。对于 HF 和 LF 臂,腰背和下肢疼痛的平均视觉模拟量表(VAS)评分均显著降低:HF 臂分别为 77%和 76%,LF 臂分别为 64%和 64%。此外,大多数受试者的 VAS、Oswestry 残疾指数、欧洲生活质量 5 维问卷、患者整体变化印象和睡眠时间均有显著改善。
这些初步结果表明,WSCS 装置在 7 个月(30 天试验期和 6 个月试验后评估)内,使用 LF 和 HF 刺激波形可显著减轻 FBSS 慢性疼痛。