University of Kansas School of Medicine, Kansas City, KS, USA.
Department of Anesthesiology and Pain Medicine, Rijnstate Hospital Arnhem, Velp, The Netherlands.
CNS Neurosci Ther. 2020 Apr;26(4):403-415. doi: 10.1111/cns.13285. Epub 2020 Feb 22.
Chronic pain is a prevalent condition which has a significant effect on the lives of those it impacts. High-frequency 10 kHz spinal cord stimulation (10 kHz SCS) has been shown to provide paresthesia-free pain relief for a wide variety of pain indications. This article summarizes the current and emerging data as they relate to the clinical use of the therapy in various pain syndromes.
A literature search was conducted using the PubMed electronic database using keywords related to 10 kHz SCS. The database was queried from 2013 to May 2019. Articles reporting clinical studies that included human subjects permanently treated with 10 kHz SCS (Senza® system) were included in the review. Recent and relevant conference proceedings known to the authors were also included.
The selected literature demonstrated significant evidence for the efficacy of 10 kHz SCS in treating chronic back and leg pain (CBLP), including a randomized, controlled trial as well as prospective and retrospective studies. One-year follow-up responder rates (pain relief ≥50%) ranged from 60% to 80%. Other studies and case series showed promising outcomes in specific conditions, including nonsurgical refractory back pain, neuropathic limb pain, complex regional pain syndrome, chronic widespread pain, chronic pelvic pain, and intractable headache. Subgroup analyses also pointed toward the potential of 10 kHz SCS being successful when low-frequency SCS has failed. The vast majority of these studies reported improved quality of life (QOL) metrics and/or reduced opioid consumption.
Level I evidence already exists for the efficacy of 10 kHz SCS in treating CBLP, supported by real-world clinical experience. Other studies demonstrate the potential of the therapy across a range of chronic pain etiologies, although larger confirmatory studies are recommended. Overall, the literature suggests that the therapy is associated with improved QOL as well as reduced opioid consumption.
慢性疼痛是一种普遍存在的病症，它对受其影响的人的生活有重大影响。高频 10kHz 脊髓刺激（10kHz SCS）已被证明可以为广泛的疼痛适应症提供无刺痛的疼痛缓解。本文总结了当前和新兴的数据，这些数据与该疗法在各种疼痛综合征中的临床应用有关。
使用 PubMed 电子数据库进行文献检索，使用与 10kHz SCS 相关的关键词。数据库从 2013 年到 2019 年 5 月进行查询。纳入的综述文章报告了包括人类受试者在内的临床研究，这些受试者永久性接受 10kHz SCS（Senza®系统）治疗。作者还纳入了最近和相关的会议记录。
所选文献为高频 10kHz SCS 治疗慢性腰背和下肢疼痛（CBLP）的疗效提供了重要证据，包括一项随机对照试验以及前瞻性和回顾性研究。一年随访时的应答率（疼痛缓解≥50%）在 60%至 80%之间。其他研究和病例系列报告了特定情况下的有希望的结果，包括非手术难治性腰背疼痛、神经性肢体疼痛、复杂区域疼痛综合征、慢性广泛性疼痛、慢性盆腔疼痛和难治性头痛。亚组分析还表明，当低频 SCS 治疗失败时，10kHz SCS 可能会成功。这些研究中的绝大多数报告了生活质量（QOL）指标的改善和/或阿片类药物消耗的减少。
已有 I 级证据表明高频 10kHz SCS 治疗 CBLP 的疗效，这得到了真实世界临床经验的支持。其他研究表明该疗法在一系列慢性疼痛病因中的潜力，尽管建议进行更大的验证性研究。总体而言，文献表明该疗法与改善 QOL 以及减少阿片类药物消耗有关。
