Comprehensive Review of the Four Stimulation Modes in Spinal Cord Stimulation (SCS) Therapy

Authors

  • Meixin Liu

DOI:

https://doi.org/10.61173/pqgmvz90

Keywords:

chronic pain, tonic SCS, high-frequency SCS, burst SCS, closed-loop SCS

Abstract

Chronic pain is a global health problem with a significant patient and socioeconomic burden. The technology of spinal cord stimulation (SCS), an efficient strategy for managing persistent pain, has undergone significant development in the previous couple of decades. The purpose of this paper is to review the development of SCS techniques, compare the efficacy of different SCS modalities, and explore future research directions. The article reviewed the development of SCS, including traditional tonic SCS, high-frequency SCS, burst SCS, and closed-loop SCS. Clinical trial and research data analysis were used to assess the safety and effectiveness of the different SCS modalities in the treatment of chronic pain. The study showed that high-frequency SCS and burst SCS were effective in relieving pain without producing paresthesia compared with conventional SCS. Closed-loop SCS provides a more personalized treatment plan by modulating stimulation through real-time feedback. However, the application of SCS still faces technical challenges, such as electrode displacement and equipment malfunction. SCS technology shows great potential in chronic pain management. With technological advances, SCS is expected to provide more effective and personalized treatment options for chronic pain patients. Subsequent investigations ought to concentrate on enhancing device stability, mitigating issues, and investigating astute and customized therapeutic alternatives.

References

[1] Breivik H, Eisenberg E, O‘Brien T; Openminds. The individual and societal burden of chronic pain in Europe: the case for strategic prioritisation and action to improve knowledge and availability of appropriate care. BMC Public Health 2013; 13: 1229.

[2] Maniadakis N, Gray A. The economic burden of back pain in the UK. Pain 2000; 84(1): 95–103.

[3] Russo, M. and Van Buyten, J.-P. HF10 SCS Clinical Summary. Pain Med, 16: 934-942. Ma Kunlong. Short term distributed load forecasting method based on big data. Changsha: Hunan University, 2014.

[4] Mailis-Gagnon A, Furlan AD, Sandoval JA, Taylor R., Spinal cord stimulation for chronic pain,Cochrane Database Syst Rev 2004(3), p. CD003783.

[5] Melzack, R.; Wall, P. Pain mechanisms: A new theory. Science 1965, 150, 971–979.

[6] He, J.; Barolat, G.; Holsheimer, J.; Struijk, J. Perception threshold and electrode position for spinal cord stimulation. Pain 1994, 59, 55–63.

[7] Mammis A., Spinal cord stimulation: principles and practice, Nova Science Publishers, Hauppauge, NY (2016).

[8] Wall, P.D. Presynaptic Control of Impulses at the First Central Synapse in the Cutaneous Pathway. Prog. Brain Res. 1964, 12, 92–118.

[9] Kumar K, Taylor RS, Jacques L, et al., The effects of spinal cord stimulation in neuropathic pain are sustained: a 24-month follow-up of the prospective randomized controlled multicenter trial of the effectiveness of spinal cord stimulation,Neurosurgery, 63 (2008), pp. 762-770.

[10] Kumar K, Taylor RS, Jacques L, et al., Spinal cord stimulation versus conventional medical management for neuropathic pain: a multicentre randomised controlled trial in patients with failed back surgery syndrome,Pain, 132, 2007, pp. 179-188.

[11] Al-Kaisy, A., Van Buyten, J.-P., Smet, I., Palmisani, S., Pang, D. and Smith, T. (2014), High-Frequency SCS for Chronic Back Pain. Pain Med, 15: 347-354.

[12] De Ridder D, Plazier M, Kamerling N, Menovsky T, Vanneste S., Burst spinal cord stimulation for limb and back pain,World Neurosurg, 80 (2013), pp. 642-649.

[13] De Ridder D, Vanneste S, Plazier M, van der Loo E, Menovsky T., Burst spinal cord stimulation: toward paresthesiafree pain suppression,Neurosurgery, 66 (2010), pp. 986-990.

[14] Al-Kaisy A, Van Buyten JP, Smet I, Palmisani S, Pang D, Smith T.,Sustained effectiveness of 10 kHz high-frequency spinal cord stimulation for patients with chronic, low back pain: 24-month results of a prospective multicenter study ,Pain Med, 15 (2014), pp. 347-354.

[15] Lopez-Garcia JA, King AE., Membrane properties of physiologically classified rat dorsal horn neurons in vitro: correlation with cutaneous sensory afferent input,Eur J Neurosci, 6 (1994), pp. 998-1007.

[16] Schu S, Slotty PJ, Bara G, von Knop M, Edgar D, Vesper J., A prospective, randomised, double-blind, placebocontrolled study to examine the effectiveness of burst spinal cord stimulation patterns for the treatment of failed back surgery syndrome, Neuromodulation, 17 (2014), pp. 443-450, doi: 10.1111/ner.12197.

[17] Lam, C.M.; Latif, U.; Sack, A.; Govindan, S.; Sanderson, M.; Vu, D.T.; Smith, G.; Sayed, D.; Khan, T. Advances in Spinal Cord Stimulation. Bioengineering 2023, 10, 185.

[18] Dirk De Ridder, Sven Vanneste, Burst and Tonic Spinal Cord Stimulation: Different and Common Brain Mechanisms, Neuromodulation: Technology at the Neural Interface, Volume 19, Issue 1, 2016, Pages 47-59, ISSN 1094-7159. Parker, J.L.; Karantonis, D.M.; Single, P.S.; Obradovic, M.; Cousins, M.J. Compound action potentials recorded in the human spinal cord during neurostimulation for pain relief. Pain 2012, 153, 593– Dean&Francis ISSN 2959-6157 601.

[19] Brooker, C.; Russo, M.; Cousins, M.; Taylor, N.; Holford, L.; Martin, R.; Boesel, T.; Sullivan, R.; Hanson, E.; Gmel, G.; et al. ECAP-Controlled Closed-Loop Spinal Cord Stimulation Efficacy and Opioid Reduction Over 24-Months: Final Results of the Prospective, Multicenter, Open-Label Avalon Study. Pain Pract. 2021, 21, 680–691.

[20] Vallejo, R.; Chakravarthy, K.; Will, A.; Trutnau, K.; Dinsmoor, D. A New Direction for Closed-Loop Spinal Cord Stimulation: Combining Contemporary Therapy Paradigms with Evoked Compound Action Potential Sensing. J. Pain Res. 2021, 14, 3909–3918.

[21] Mekhail, N.; Levy, R.M.; Deer, T.R.; Kapural, L.; Li, S.; Amirdelfan, K.; Hunter, C.W.; Rosen, S.M.; Costandi, S.J.; Falowski, S.M.; et al. Long-term safety and efficacy of closedloop spinal cord stimulation to treat chronic back and leg pain (Evoke): A double-blind, randomised, controlled trial. Lancet Neurol. 2020, 19, 123–134.

[22] T. Cameron,Safety and efficacy of spinal cord stimulation for the treatment of chronic pain: a 20-year literature review,J Neurosurg, 100 (Suppl Spine 3) (2004), pp. 254-267

[23] K. Kumar, J.R. Wilson, R.S. Taylor, S. Gupta, Complications of spinal cord stimulation, suggestions to improve outcome, and financial impact,J Neurosurg Spine, 5 (2006), pp. 191-203

[24] N.A. Mekhail, M. Mathews, F. Nageeb, M. Guirguis, M.N. Mekhail, J. Cheng, Retrospective review of 707 cases of spinal cord stimulation: indications and complications,Pain Pract, 11 (2011), pp. 148-153.

[25] T. Cameron, K.M. Alo,Effects of posture on stimulation parameters in spinal cord stimulation,Neuromodulation, 1 (1998), pp. 177-183

[26] Barolat G, Sharan AD: Spinal cord stimulation for chronic pain management. Semin Neurosurg 15:151-157, 2004.

[27] Lam, C.M.; Latif, U.; Sack, A.; Govindan, S.; Sanderson, M.; Vu, D.T.; Smith, G.; Sayed, D.; Khan, T. Advances in Spinal Cord Stimulation. Bioengineering 2023, 10, 185.

[28] De Ridder D, Plazier M, Kamerling N, Menovsky T, Vanneste S.,Burst spinal cord stimulation for limb and back pain,World Neurosurg, 80 (2013), pp. 642-649.

[29] Chakravarthy, Krishnan & Reddy, Rajiv & Al-Kaisy, Adnan & Yearwood, Thomas & Grider, Jay. (2021). A Call to Action Toward Optimizing the Electrical Dose Received by Neural Targets in Spinal Cord Stimulation Therapy for Neuropathic Pain. Journal of Pain Research. 14. 2767-2776. 10.2147/JPR. S323372.

[30] Hunter CW, Pope J. Closed loop spinal cord stimulation. ASRA News 2021;46.

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Published

2024-12-31

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Vol. 2 No. 6 (2024): Volume 2, Issue 6

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