High-frequency stimulation

Abstract

Spinal cord stimulation (SCS) has become an integral treatment option for many patients suffering from chronic, intractable neuropathic pain in the trunk and limbs. New iterations of SCS have been introduced, but the efficacy of such developments so far has been focused on providing more effective paresthesia coverage in the area of pain for appropriate patients. The advent of a new high-frequency SCS system, commercially available as HF10™ therapy, has created a new realm in neuromodulation where paresthesia coverage is no longer relevant. Moreover, HF10 therapy has been shown to be superior to traditional, paresthesia-based, low-frequency SCS in a large, level I randomized controlled study (The SENZA-RCT) [1]. In May of 2015, the evidence from the first of its kind RCT study in neuromodulation, along with strong evidence from the European and Australian experience, led to the approval of the SENZA® system, capable of HF10 SCS therapy, in the United States. HF10 therapy has since become increasingly popular among neuromodulators for the treatment of chronic low back and leg pain, among other indications commonly treated with SCS. The remarkable efficacy of HF10 therapy has helped this technology in finding itself among one of the most popular technologies in SCS in the United States and around the world. This chapter outlines some of the evidence supporting the safety and efficacy of SCS and HF10 therapy and provides a detailed, step-by-step guide for safe and efficient implementation of HF10 therapy SCS for appropriate patients.