Chapter 54 - Ten Kilohertz (10 kHz) High-Frequency Spinal Cord Stimulation

Abstract

Spinal cord stimulation (SCS) has been shown to be a safe and efficacious treatment for chronic pain of various etiologies. A recent technological development, in the form of 10kHz high-frequency SCS, offers clinically and statistically significant better pain relief for chronic back and leg pain when compared to traditional low-frequency paresthesia-based SCS. This 10kHz high-frequency SCS is being investigated for other chronic pain syndromes, such as upper-extremity and neck pain and peripheral polyneuropathy. Available clinical evidence suggests that chronic pain refractory to other treatment options responds well to this therapy, allowing patients to regain functionality and improve their quality of life. The therapy features a simple SCS implantation algorithm without the need to test for paresthesias with risks and side-effects that are found in traditional SCS. While the nature of the underlying mechanism by which 10kHz high-frequency SCS provides such pain relief is unclear, several preclinical and clinical studies presented at international meetings suggest a few distinct mechanisms of pain relief previously not documented when traditional low-frequency SCS is used. Careful preoperative patient selection is still a key factor to long-term success of this SCS therapy.