Retrospective Assessment of Salvage to 10 kHz Spinal Cord Stimulation (SCS) in Patients Who Failed Traditional SCS Therapy: RESCUE Study

Retrospective Assessment of Salvage to 10 kHz Spinal Cord Stimulation (SCS) in Patients Who Failed Traditional SCS Therapy: RESCUE Study

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Leonardo Kapural,1 click here Dawood Sayed,2 Brian Kim,2 Caroline Harstroem,1 James Deering1 1Carolinas Pain Institute, Winston-Salem, NC 27103, USA; 2Department of Anesthesiology, University of Kansas, Kansas City, KS, USACorrespondence: Leonardo Kapural Email lkapuralmd@gmail.comBackground and Objectives: A randomized clinical trial demonstrated that 10 kHz SCS (10kHz-SCS) therapy is superior to traditional low-frequency SCS (LF-SCS) at 12- and 24-month clinical follow-ups and led to Food and Drug Administration (FDA) approval of the therapy.The results of the study led our practices to trial 10kHz-SCS in patients who had not maintained pain relief with LF-SCS therapy.

Here, we report a large set of data from two clinical sites to assess if 10kHz-SCS is an effective salvage modality when LF-SCS fails.Methods: We conducted a retrospective chart review of 120 patients across two clinical sites who had LF-SCS implants and were salvaged with 10kHz-SCS.Results: Data were analyzed from 105 patients between 28 and 90 years old (median 60) with chronic pain for 13.

6 years.The mean duration of LF-SCS therapy was 4.66± 3.

9 years.The average Visual Analog Scale (VAS) decreased from 8.30± 1.

4 (median of 8) cm to 3.32± 2.0 (median of 3) cm at 12 months and 3.

36± 2.0 (median of 3) cm at the most recent clinic visit (p< 0.001) following salvage therapy.

Pain relief of 50% or more was obtained in 85 read more out of 105 (81%) patients.Opioid usage decreased from 60.3± 77.

1 mg to 32.1± 44.0 mg MSO4 equivalents (p = 0.

001) at 12 months after salvage therapy.Conclusion: Eighty-one percent of patient cases reviewed, where LF-SCS had failed, achieved > 50% pain relief with 10kHz-SCS, and almost all exhibited some clinical improvement.Therefore, 10kHz-SCS should be considered an appropriate option to rescue failed LF-SCS.

Keywords: spinal cord stimulation, high-frequency 10 kHz spinal cord stimulation, low-frequency spinal cord stimulation, neuromodulation, lower back pain, lumbosacral radiculopathy, post-laminectomy syndrome, failed back surgery syndrome.