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New modalities of neurostimulation: high frequency and dorsal root ganglion.

Publication ,  Journal Article
Roy, LA; Gunasingha, RMKD; Rauck, R
Published in: Curr Opin Anaesthesiol
October 2016

PURPOSE OF REVIEW: Neurostimulation is a well tolerated, cost-efficient, and effective method to treat chronic pain. Although spinal cord stimulation (SCS) has been shown to help patients, newer modalities such as burst, kilohertz-frequency, and dorsal root ganglion stimulation may provide greater pain relief, fewer paresthesias, and better outcomes. RECENT FINDINGS: Burst stimulation, programed as five-impulse burst at a frequency of 500 Hz, delivers more charge per second than conventional stimulation. Trials of burst stimulation have shown superior pain relief, decreased paresthesias, and patient preference compared with conventional SCS. Kilohertz-frequency SCS uses low-amplitude, high-frequency (10 kHz), and short-duration pulses. The SENZA trial showed superiority in both back and leg pain with greater pain relief as well as decreased opioid use. Dorsal root ganglion stimulation stimulates the ganglion cells allowing for precise targeting of pain regions. Multiple studies, including the ACCURATE trial, have shown superior pain relief in multiple conditions. SUMMARY: Improvements in pain control and patient satisfaction suggest that these new stimulation patterns will greatly increase the utility of neurostimulation; however, clinical trials with broader patient populations have to be done to support more extensive use of these therapies.

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Published In

Curr Opin Anaesthesiol

DOI

EISSN

1473-6500

Publication Date

October 2016

Volume

29

Issue

5

Start / End Page

590 / 595

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Spinal Cord Stimulation
  • Paresthesia
  • Humans
  • Ganglia, Spinal
  • Clinical Trials as Topic
  • Chronic Pain
  • Anesthesiology
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
 

Citation

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Roy, L. A., Gunasingha, R. M. K. D., & Rauck, R. (2016). New modalities of neurostimulation: high frequency and dorsal root ganglion. Curr Opin Anaesthesiol, 29(5), 590–595. https://doi.org/10.1097/ACO.0000000000000379
Roy, Lance A., Rathnayaka Mudiyanselage Kalpanee D. Gunasingha, and Richard Rauck. “New modalities of neurostimulation: high frequency and dorsal root ganglion.Curr Opin Anaesthesiol 29, no. 5 (October 2016): 590–95. https://doi.org/10.1097/ACO.0000000000000379.
Roy LA, Gunasingha RMKD, Rauck R. New modalities of neurostimulation: high frequency and dorsal root ganglion. Curr Opin Anaesthesiol. 2016 Oct;29(5):590–5.
Roy, Lance A., et al. “New modalities of neurostimulation: high frequency and dorsal root ganglion.Curr Opin Anaesthesiol, vol. 29, no. 5, Oct. 2016, pp. 590–95. Pubmed, doi:10.1097/ACO.0000000000000379.
Roy LA, Gunasingha RMKD, Rauck R. New modalities of neurostimulation: high frequency and dorsal root ganglion. Curr Opin Anaesthesiol. 2016 Oct;29(5):590–595.

Published In

Curr Opin Anaesthesiol

DOI

EISSN

1473-6500

Publication Date

October 2016

Volume

29

Issue

5

Start / End Page

590 / 595

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Spinal Cord Stimulation
  • Paresthesia
  • Humans
  • Ganglia, Spinal
  • Clinical Trials as Topic
  • Chronic Pain
  • Anesthesiology
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology