scholarly journals Effectiveness of 10-kHz High-frequency spinal cord stimulation in diabetic polyneuropathy refractory to medical management: two case reports

2021 ◽  
Vol 24 (3) ◽  
pp. 224
Author(s):  
De Carolis, G.

The sensorimotor diabetic polyneuropathy represents a serious health problem, as it is responsible for an increased risk of mortality and substantial morbidity, resulting from foot ulceration, amputations, and impaired quality of life. Appropriate drug treatments are often unsuccessful at providing adequate pain relief and the use of minimally invasive procedures such as spinal cord stimulation (SCS) represents a valid therapeutic choice. Patient’s medical history and characteristics as well as clinical indication for the procedure influence the clinician in choosing the right type of therapy. Here we describe two cases suffering from type 2 diabetes mellitus and sensorimotor polyneuropathy, refractory to conventional medical management: in both cases, the 10-kHz high-frequency SCS therapy led to a long-term clinically meaningful relief of symptomatology which was evaluated in terms of: complete discharge of analgesic drugs, significant reduction in the intensity of perceived pain, recovery of motor function, improvement of mood tone and sleep quality. KEY WORDS diabetic sensorimotor polyneuropathy; neuropathic pain; 10-kHz high-frequency spinal cord stimulation.

2021 ◽  
pp. E407-E423

BACKGROUND: Evidence suggests that dorsal root ganglion stimulation (DRGS) is a more effective treatment for focal neuropathic pain (FNP) compared with tonic, paresthesia-based dorsal column spinal cord stimulation (SCS). However, new advancements in waveforms for dorsal column SCS have not been thoroughly studied or compared with DRGS for the treatment of FNP. OBJECTIVES: The purpose of this review was to examine the evidence for these novel technologies; to highlight the lack of high-quality evidence for the use of neuromodulation to treat FNP syndromes other than complex regional pain syndrome I or II of the lower extremity; to emphasize the absence of comparison studies between DRGS, burst SCS, and high-frequency SCS; and to underscore that consideration of all neuromodulation systems is more patient-centric than a one-size-fits-all approach. STUDY DESIGN: This is a review article summarizing case reports, case series, retrospective studies, prospective studies, and review articles. SETTING: The University of Miami, Florida. METHODS: A literature search was conducted from February to March 2020 using the PubMed and EMBASE databases and keywords related to DRGS, burst SCS, HF10 (high-frequency of 10 kHz), and FNP syndromes. All English-based literature from 2010 reporting clinical data in human patients were included. RESULTS: Data for the treatment of FNP using burst SCS and HF10 SCS are limited (n = 11 for burst SCS and n = 11 for HF10 SCS). The majority of these studies were small, single-center, nonrandomized, noncontrolled, retrospective case series and case reports with short follow-up duration. To date, there are only 2 randomized controlled trials for burst and HF10 for the treatment of FNP. LIMITATIONS: No studies were available comparing DRGS to HF10 or burst for the treatment of FNP. Data for the treatment of FNP using HF10 and burst stimulation were limited to a small sample size reported in mostly case reports and case series. CONCLUSIONS: FNP is a complex disease, and familiarity with all available systems allows the greatest chance of success. KEY WORDS: Dorsal root ganglion, high frequency, burst, spinal cord stimulation, neuromodulation, focal neuropathic pain


2016 ◽  
Vol 21 (5) ◽  
pp. 795-803 ◽  
Author(s):  
M. van Beek ◽  
M. van Kleef ◽  
B. Linderoth ◽  
S.M.J. van Kuijk ◽  
W.M. Honig ◽  
...  

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Chiaki Yamada ◽  
Aiko Maeda ◽  
Katsuyuki Matsushita ◽  
Shoko Nakayama ◽  
Kazuhiro Shirozu ◽  
...  

Abstract Background Patients with spinal cord injury (SCI) frequently complain of intractable pain that is resistant to conservative treatments. Here, we report the successful application of 1-kHz high-frequency spinal cord stimulation (SCS) in a patient with refractory neuropathic pain secondary to SCI. Case presentation A 69-year-old male diagnosed with SCI (C4 American Spinal Injury Association Impairment Scale A) presented with severe at-level bilateral upper extremity neuropathic pain. Temporary improvement in his symptoms with a nerve block implied peripheral component involvement. The patient received SCS, and though the tip of the leads could not reach the cervical vertebrae, a 1-kHz frequency stimulus relieved the intractable pain. Conclusions SCI-related symptoms may include peripheral components; SCS may have a considerable effect on intractable pain. Even when the SCS electrode lead cannot be positioned in the target area, 1-kHz high-frequency SCS may still produce positive effects.


2012 ◽  
Vol 109 (5) ◽  
pp. 837 ◽  
Author(s):  
W.A. Pluijms ◽  
R Slangen ◽  
M Bakkers ◽  
C.G. Faber ◽  
I.S.J. Merkies ◽  
...  

2020 ◽  
Vol 8 (3) ◽  
pp. 132-137
Author(s):  
Zhuqiang Cheng

A 46-year-old female patient experienced severe pain in both lower limbs following a traffic accident in 2008. The pain mainly presented in her feet; she also experienced sensory impairment, convulsions, and exercise function disorders. She was diagnosed with neuropathic pain, and no medicine had any remarkable effect. Therefore, spinal cord stimulation (SCS) was performed in October 2019. Her pain did not reduce after the initial adoption of conventional SCS until the application of high frequency SCS (HF-SCS). At the 6-month follow-up, the pain in her lower limbs was considerably reduced, lower limb motor function was slightly improved, and muscle twitching in both feet disappeared.


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