Abraham Mickey E, Gold Justin, Dondapati Akhil, Sheaffer Kristin, Gendreau Julian L, Mammis Antonios
Neurological Surgery, University of California, La Jolla, USA.
Department of Neurosurgery, Rutgers New Jersey Medical School, Newark, USA.
Cureus. 2021 Aug 16;13(8):e17220. doi: 10.7759/cureus.17220. eCollection 2021 Aug.
Introduction Neuromodulation is an evolving and increasingly popular therapy for chronic pain management. Recent data suggest that novel waveforms have demonstrated greater benefit over traditional spinal cord stimulation (SCS). The authors conducted a retrospective review of patients undergoing high-frequency 10 kHz SCS at a single tertiary medical center for the purpose of contributing further evidence to this growing body of data. The literature of high-frequency SCS published to date was also reviewed. Methods A retrospective chart review was performed for patients with chronic pain syndrome, including failed back surgery syndrome and sciatica alone, who underwent high-frequency SCS at 10 kHz. This data was analyzed using R software (R Foundation for Statistical Computing, Vienna, Austria) for statistical analysis. The PubMed database was searched for relevant articles using the search terms "high frequency," "10 kHz," and "spinal cord stimulation." All relevant studies conducted to date were included in this literature review. Results Twenty-one patients had complete follow-up data and were included in this study. Of the 21 patients, 85.7% subjectively reported post-operative pain relief while 71.4% of the total patients reported pain relief by ≥ 50%. There was a statistically significant decrease in mean VAS scores from pre-operative to 12-months post-operative (8.52 vs 4.37, p < 0.001). Additionally, 76.5% of patients subjectively reported improvements in sleep and activities of daily living. Recent studies indicate that high-frequency SCS appears to be a viable option for delivering quality pain relief in patients for chronic regional pain syndrome, failed back surgery syndrome, sciatica, and also pain in the upper cervical region of the spine. Conclusion This article provides evidence both with the authors' own institutional data and from the currently published literature for the efficacy of using high-frequency SCS at 10 kHz as a first-line programming option for patients undergoing SCS.
引言 神经调节是一种不断发展且越来越受欢迎的慢性疼痛管理疗法。最近的数据表明，新型波形在治疗效果上已显示出比传统脊髓刺激（SCS）更具优势。作者在一家三级医疗中心对接受高频10kHz脊髓刺激的患者进行了回顾性研究，旨在为这一不断增长的数据提供更多证据。同时，还对迄今为止发表的高频脊髓刺激文献进行了综述。
方法 对患有慢性疼痛综合征（包括腰椎手术失败综合征和单纯坐骨神经痛）且接受10kHz高频脊髓刺激的患者进行回顾性病历审查。使用R软件（R统计计算基金会，奥地利维也纳）对这些数据进行统计分析。通过搜索词“高频”、“10kHz”和“脊髓刺激”在PubMed数据库中检索相关文章。本次文献综述纳入了迄今为止所有相关研究。
结果 21例患者有完整的随访数据并纳入本研究。在这21例患者中，85.7%主观报告术后疼痛缓解，而71.4%的患者报告疼痛缓解≥50%。从术前到术后12个月，平均视觉模拟评分（VAS）有统计学显著下降（8.52对4.37，p<0.001）。此外，76.5%的患者主观报告睡眠和日常生活活动有所改善。最近的研究表明，高频脊髓刺激似乎是为慢性区域疼痛综合征、腰椎手术失败综合征、坐骨神经痛以及脊柱上颈部疼痛患者提供高质量疼痛缓解的可行选择。
结论 本文通过作者自身机构的数据以及当前已发表的文献，为将10kHz高频脊髓刺激作为脊髓刺激患者的一线编程选择的疗效提供了证据。
