10 kHz SCS for chronic postsurgical pain: Results from a 12-month prospective, multicenter study.
Chronic postsurgical pain (CPSP) can be caused byperipheral nerve injury (PNI) resulting from surgical procedures and has a significant neuropathic component. This prospective, single-arm study was conducted to document the effectiveness of 10 kilohertz spinal cord stimulation (10 kHz SCS) as a treatment for patients with CPSP.Subjects with CPSP who were refractory to conventional medical interventions and reported pain scores of ≥5 cm on a 10-cm visual analog scale (VAS) underwent trial stimulations lasting up to 14 days. Epidural leads were implanted at locations appropriate for the primary area of pain, and trials resulting in ≥40% pain relief were considered successful. Subjects with successful trials were implanted with permanent 10 kHz SCS system and were followed for 12 months after implantation.Of 34 subjects who underwent trial stimulation, 1 was withdrawn early and 29 (87.9%) had a successful trial and received a permanent implant.After 12 months of treatment, mean VAS score fell by 6.5 cm, the response rate was 88.0% (22/25), and 18 subjects (62.1%) were remitters with VAS scores sustained at ≤3.0 cm. All components of the SF-MPQ-2 were significantly reduced including affective descriptors of pain. Pain catastrophizing and vigilance, patient function, physical and mental well-being, and sleep quality all improved over the course of the study. There were no neurologic deficits reported in the study.10 kHz SCS is effective, and tolerated in patients with CPSP, and further study of its clinical application in this population is warranted.