New modalities of neurostimulation: excessive frequency and dorsal root ganglion.
Curr Opin Anaesthesiol. 2016 Oct;29(5):590-5
Authors: Roy LA, Gunasingha RM, Rauck R
PURPOSE OF REVIEW: Neurostimulation is a effectively tolerated, cost-efficient, and efficient technique to deal with persistent ache. Though spinal wire stimulation (SCS) has been proven to assist sufferers, newer modalities equivalent to burst, kilohertz-frequency, and dorsal root ganglion stimulation could present better ache aid, fewer paresthesias, and higher outcomes.
RECENT FINDINGS: Burst stimulation, programed as five-impulse burst at a frequency of 500?Hz, delivers extra cost per second than typical stimulation. Trials of burst stimulation have proven superior ache aid, decreased paresthesias, and affected person choice in contrast with typical SCS. Kilohertz-frequency SCS makes use of low-amplitude, high-frequency (10?kHz), and short-duration pulses. The SENZA trial confirmed superiority in each again and leg ache with better ache aid in addition to decreased opioid use. Dorsal root ganglion stimulation stimulates the ganglion cells permitting for exact focusing on of ache areas. A number of research, together with the ACCURATE trial, have proven superior ache aid in a number of circumstances.
SUMMARY: Enhancements in ache management and affected person satisfaction counsel that these new stimulation patterns will enormously enhance the utility of neurostimulation; nonetheless, medical trials with broader affected person populations need to be executed to help extra in depth use of those therapies.
PMID: 27455042 [PubMed – indexed for MEDLINE]