High-Dose Spinal Cord Stimulation for Treatment of Chronic Low Back Pain and Leg Pain in Patients With FBSS, 12-Month Results: A Prospective Pilot Study

Long-Term Efficacy of a Novel Spinal Cord Stimulation Clinical Workflow Using Kilohertz Stimulation: Twelve-Month Results From the Vectors Study

“…Published long-term outcomes with the use of HD stimulation parameters as part of a clinical workflow is limited, and this study adds longitudinal outcomes with a large sample size to the literature. Recent prospective studies of HD therapies using 1-1.2 kHz have been short-term (10,6,33,16), have had small sample sizes (34), or have only assessed HD after conventional programming (35). In contrast, the Vectors study provides needed additional prospective 12-months outcome evidence from a large cohort, with a majority of patients programmed to HD therapy.…”

The Long-Term Response to High-Dose Spinal Cord Stimulation in Patients With Failed Back Surgery Syndrome After Conversion From Standard Spinal Cord Stimulation: An Effectiveness and Prediction Study

“…One of those new paradigms is based on the concept of enabling longer duty cycles, a term indicating the percentage of time in which the stimulation signal is active (i.e., "on" time). Higher duty cycles implicate higher energy delivery from the lead to the spinal cord (i.e., increased "current density") (10)(11)(12). This so-called "high-dose spinal cord stimulation (HD-SCS)" is also based on paresthesia-guided placement of the SCS-leads, like standard SCS, but achieves higher duty cycles by increasing the frequency and/or the pulse width with a subthreshold amplitude (12).…”

“…Only patients with a successful trial, usually defined as ≥50% pain relief, eventually receive a definitive implant (10,13). Nevertheless, in some patients, these initial pain reductions achieved during the trial are not maintained over time (14,15).…”

The Added Value of High Dose Spinal Cord Stimulation in Patients with Failed Back Surgery Syndrome after Conversion from Standard Spinal Cord Stimulation

“…Alternative modes of SCS have been investigated during recent years, with as a main focus offering new treatment regiments for patients with failed conventional SCS, who lost their initial effectiveness over time [ 18 , 19 ]. High dose spinal cord stimulation (HD-SCS) is such a novel, subsensory SCS paradigm, based on pulse density rather than stimulating at a specific frequency.…”

“…High dose spinal cord stimulation (HD-SCS) is such a novel, subsensory SCS paradigm, based on pulse density rather than stimulating at a specific frequency. Studies have already showed that HD-SCS offers effective pain relief and higher patient satisfaction than conventional SCS [ 18 , 19 ]. Theoretically, prolonging the effectiveness of SCS treatment by conversion to HD-SCS after unsatisfactory conventional SCS could offer significant benefits not only from a clinical, but also from a health economical perspective.…”