Use of High-Frequency 10-kHz Spinal Cord Stimulation in the Treatment of Persistent Spinal Pain Syndrome Type 2: A Systematic Review.

OBJECTIVES

In 2015, 10-kHz high-frequency (10-kHz) spinal cord stimulation (SCS) received Food and Drug Administration approval to treat persistent spinal pain syndrome type 2 (PSPS-2). The outcomes of 10-kHz SCS on PSPS-2 have not been systematically reviewed. We systematically reviewed the relevant literature and hypothesized that 10-kHz SCS is safe and effective in managing pain in patients with PSPS-2.

MATERIALS AND

METHODS

PUBMED and EMBASE data bases were searched with the query ((spinal cord stimulator) OR (spinal cord stimulation) OR (SCS)) AND (pain) AND ((10 khz) OR (10-khz) OR (HF10) OR (HF-10)) on April 24, 2024.

RESULTS

The search produced 636 nonduplicate articles. After applying the inclusion/exclusion criteria, nine studies were selected. Seven studies reported the percentage passing 10-kHz SCS trial, and the weighted average based on the number of patients was 87.3% success rate overall. Three studies measured overall pain on the visual analog scale (VAS), and six measured VAS back and leg separately. The weighted average for VAS overall, back, and leg was 8.1 (preoperation), 4.7 (postoperation); 7.0 (preoperation), 2.0 (postoperation); and 5.7 (preoperation), 1.6 (postoperation), respectively. Two studies evaluated the Beck Depression Index, and the weighted average was 23.8 (preoperation) and 14.0 (postoperation). Three studies evaluated the Oswestry Disability Index (ODI), and the weighted average was 48.3 (preoperation) and 30.6 (postoperation). Two studies compared burst stimulation with 10-kHz SCS, and both found no difference in back pain scores, whereas both studies found greater improvement in leg pain in the burst groups. Two studies compared low-frequency SCS with 10-kHz SCS, and both studies found no significant difference in VAS or ODI scores between the two treatments. There were no reported unanticipated adverse device effects across the studies.

CONCLUSION

For many patients with refractory PSPS-2, 10-kHz SCS is a safe, effective treatment, but there is a lack of evidence of its superiority to burst or traditional SCS.