Therapy Habituation at 12 Months: Spinal Cord Stimulation Versus Dorsal Root Ganglion Stimulation for Complex Regional Pain Syndrome Type I and II

Levy, Robert M.; Mekhail, Nagy; Kramer, Jeffrey; Poree, Lawrence; Amirdelfan, Kasra; Grigsby, Eric; Staats, Peter S.; Burton, Allen W.; Burgher, Abram H.; Scowcroft, James; Golovac, Stan; Kapural, Leonardo; Paicius, Richard; Pope, Jason E.; Samuel, S.; McRoberts, W. Porter; Schaufele, Michael K.; Kent, Alexander R.; Raza, Adil; Deer, Timothy R.

doi:10.1016/j.jpain.2019.08.005

Cited by 41 publications

(37 citation statements)

References 23 publications

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“…It has been demonstrated in rodents, that exogenous opioid use leads to μ receptor internalization, and in turn tolerance, however, these same receptors did not demonstrate this to endogenous opioids, and therefore did not develop tolerance for endogenous opioids (164). This lack of tolerance to endogenous opioids may be responsible for the fact that DRG‐S is associated with less habituation, or tolerance, than SCS at one year in patients with CRPS I (165).…”

Section: T12 Drg‐s For Axial Lbp: Integrating the Evidencementioning

confidence: 99%

The Pathways and Processes Underlying Spinal Transmission of Low Back Pain: Observations From Dorsal Root Ganglion Stimulation Treatment

Chapman

Groenen

Vissers

et al. 2021

Neuromodulation: Technology at the Neural Interface

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Section: T12 Drg‐s For Axial Lbp: Integrating the Evidencementioning

confidence: 99%

The Pathways and Processes Underlying Spinal Transmission of Low Back Pain: Observations From Dorsal Root Ganglion Stimulation Treatment

Chapman

Groenen

Vissers

et al. 2021

Neuromodulation: Technology at the Neural Interface

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“…In addition, patients receiving DRGS were found to have less therapy habituation as compared to patients treated with Tonic SCS at 9 and 12 months. 57 Also the amount and intensity of paresthesias were found to be less with DRGS over Tonic SCS, and DRGS was found to be more stable in response to changes in body position as compared to Tonic SCS. 23 Finally, some DRGS patients even achieved paresthesia-free analgesia.…”

Section: New Stimulation Location: the Dorsal Root Ganglionmentioning

confidence: 89%

Spinal cord stimulation in chronic neuropathic pain: mechanisms of action, new locations, new paradigms

Joosten

Franken

2020

Pain

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“…Previous studies have reported an explantation rate of up to 23.9% at long‐term follow‐up (23), being accompanied by high financial costs for patients as well as health‐care systems. The most cited explanation for this loss of therapeutic effect is habituation after chronic stimulation (24,25). However, from a pathophysiological perspective, currently there is not enough evidence to support this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

1.2 kHz High-Frequency Stimulation as a Rescue Therapy in Patients With Chronic Pain Refractory to Conventional Spinal Cord Stimulation

Andrade

Heiden

Visser‐Vandewalle

et al. 2021

Neuromodulation: Technology at the Neural Interface

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Objectives: We aimed to investigate the efficacy of new subperception stimulation paradigms including 1.2 kHz-highfrequency stimulation (HFS) and advanced-HFS field-shaping algorithm (dorsal horn HFS [DHHFS]) in refractory cases which initially benefited from conventional spinal cord stimulation (SCS) and lost the effect throughout time.Materials and Methods: In the context of a rescue-therapy, patients underwent externalization of the implanted SCS-leads and were tested with multiple combinations of new SCS paradigms. Pain intensity was analyzed using the numeric rating scale (NRS), and data were collected preoperatively and at multiple postoperative follow-ups.Results: Thirty-seven patients underwent externalization of the leads. Mean preoperative NRS-score was 8.1/10 points (SD ± 0.9) for the ON-stimulation period. Patients received a combination of either tonic, burst and 1.2 kHz-HFS, or burst and 1.2 kHz-HFS, DHHFS, or 1.2 kHz-HFS and DHHFS, or 1.2 kHz-HFS alone. The mean postoperative NRS-score after the testingphase was 3.8/10 points (SD ± 2.5), showing a 48.0% mean reduction (p < 0.001). In total, 29 patients reported a significant reduction above 50% in NRS-scores and therefore were reimplanted with new generators that could deliver the new paradigms. Eight patients underwent full SCS-system explantation. The patients who continued with the new paradigms (n = 29) reported mean NRS-scores of 3.5/10 points (SD ± 1.7) 12 months postoperatively, still showing a significant reduction of 43.3% when compared to preoperative scores (p < 0.001). Conclusion:Rescue-therapy with combination of multiple waveforms, including tonic, burst, 1.2 kHz-HFS, and DHHFS, was associated with a significant pain relief in patients with failed conventional SCS. This approach is a safe and efficient and should be considered before explantation of the SCS-system.

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Therapy Habituation at 12 Months: Spinal Cord Stimulation Versus Dorsal Root Ganglion Stimulation for Complex Regional Pain Syndrome Type I and II

Cited by 41 publications

References 23 publications

The Pathways and Processes Underlying Spinal Transmission of Low Back Pain: Observations From Dorsal Root Ganglion Stimulation Treatment

The Pathways and Processes Underlying Spinal Transmission of Low Back Pain: Observations From Dorsal Root Ganglion Stimulation Treatment

Spinal cord stimulation in chronic neuropathic pain: mechanisms of action, new locations, new paradigms

1.2 kHz High-Frequency Stimulation as a Rescue Therapy in Patients With Chronic Pain Refractory to Conventional Spinal Cord Stimulation

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