Burst Stimulation: An Innovative Waveform Strategy for Spinal Cord Stimulation

Abstract

Since the advent of spinal cord stimulation (SCS) or tonic spinal cord stimulation (t-SCS), developed by Norman Shealy in 1967, dorsal column stimulation has continued to evolve, primarily focused on lead innovations. Disadvantages to current SCS strategies are inherent to how it works: it requires perceived congruent therapeutic paresthesia overlying the typical painful area. Challenges include the ability to place the paresthesia in congruent areas, the positionality associated with the required perception, and the need for the patient to consider the paresthesia therapeutic. New innovations in waveform strategies are moving from the need to create a perceived paresthesia to achieve analgesia. This chapter explores one such innovation, Burst stimulation (Burst-SCS). It is important to appreciate that Burst-SCS is currently under investigation in the United States and is not approved by the U.S. Food and Drug Administration or available for use.