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ESRA19-0389 Pulse dosing of 10 khz paresthesia-independent spinal cord stimulation provides same efficacy with substantial reduction of device recharge time
  1. D Provenzano1,
  2. C Yu2,
  3. P Verrills3,
  4. M Guirguis4,
  5. N Harrison4 and
  6. K Bradley5
  1. 1Pain Diagnostics and Interventional Care, Pain Management, Sewickley, USA
  2. 2Swedish Medical Center, Pain Management, Seattle, USA
  3. 3Metro Pain Group, Pain Management, Clayton VIC, Australia
  4. 4Ochsner Medical Center, Pain Management, New Orleans, USA
  5. 5Nevro, Research, Glendale, USA


Background and aims High frequency 10 kHz paresthesia-independent spinal cord stimulation (10kHzSCS) has demonstrated statistical and clinical superiority over traditional, low-frequency paresthesia-based SCS in relief of chronic back and leg pain. The purpose of this study is to assess the ability of percent pulse dosing (%PD=alternating 10kHzSCS ON and OFF times) to reduce device recharge time while maintaining efficacy.

Methods Permanently-implanted subjects successfully using 10kHzSCS at 100%PD to treat back pain with or without leg pain for >3 months were enrolled. After a 1-week baseline period of documenting their pain using a 0–10 numerical rating scale (NRS) using 100%PD, all subjects were reprogrammed to 14%PD for 7–10 days. If subjects preferred 14%PD to 100%PD, they were programmed to 3%PD; otherwise, they were programmed to 50%PD; subjects used this program for 7–10 days. After these initial%PD evaluations, each subject entered a 3-month uncontrolled observational period where the subject was requested but not limited to use their most preferred%PD program. At the end of 3 months, the subject completed a 7-day NRS diary and indicated a final%PD program preference.

Results 6/15 subjects preferred 3%PD, 3/15 preferred 14%PD, 3/15 preferred 50%PD, and 3/15 preferred 100%PD. Average daily charge durations: 3%PD=8.6±0.5 min, 14%PD=14±7 min, 50%PD=33±3.3 min, 100%PD=38.6±6.5 min. Average back pain scores: 3%PD=1.8±1.4, 14%PD=2.0±1.7, 50%PD=4.1±0.7, 100%PD=1.7±1.4, all P>0.1 from 100%PD.

Conclusions In this study, 80% of 10kHzSCS responders maintained efficacy and reduced device charging times approximately 64% using <100%PD. These trends suggest that 10kHzSCS therapy may be successfully employed with device charging times approximately 30% shorter than traditional SCS.

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